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medRxiv PreprintsInternational29 October 2026

Pupil size-resting state network coupling in major depressive disorder: a longitudinal iTBS study

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Altered central-peripheral autonomic nervous system communication plays a key role in major depressive disorder (MDD). In this context, pupillary dynamics may be considered a non-invasive peripheral proxy of treatment-related changes during intermittent theta-burst stimulation (iTBS) in MDD. However, the relationship between spontaneous pupillary fluctuations and the resting-state functional networks (RSNs) involved in MDD is still underexplored. Here, we investigated longitudinal changes in pupil-RSN coupling in patients with MDD undergoing an iTBS intervention. Resting-state functional magne
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