rTMS for Depression

Inclusion criteria

• Male or female subjects 18 to 80 years of age
• DSM V diagnosis of a major depressive episode Subjects must have an initial score of at least 20 on the HAMD at screen
• rTMS is clinically indicated
• Patient is competent to provide informed consent

Exclusion criteria

• Lifetime DSM-V diagnosis of schizophrenia, schizoaffective disorder, psychotic depression or any other psychotic disorder as defined in the DSM-V
• Current (within the last year) diagnosis of anxiety disorder, obsessive- compulsive disorder, or eating disorder that precedes the onset of the current episode of depression and is the primary diagnosis
• Current diagnosis of delirium, dementia, or amnestic amnesiac disorder
• Diagnosis of mental retardation
• Baseline Mini Mental State Exam (MMSE) score < 21 or a total score falling two standard deviations below the age- and education-adjusted mean, whichever is less
• Any active general medical condition or CNS disease which can affect cognition or response to treatment
• Current (within the past three months) diagnosis of active substance dependence, or active substance abuse within the past week as indicated by self-report.
• ECT or rTMS within three months
• Pregnancy as indicated by self-report
• MRI contraindications
• Implanted electronic device or metal implant in the head and neck region (DBS, cochlear implant, etc)
• Change in the dose of psychotropic medications within the past week

Inclusion criteria

for healthy volunteers:

• Male or female between age 18 and 80
• Patient is competent to provide informed consent

Exclusion criteria

for healthy volunteers:

• Lifetime history of major chronic mental illness, such as schizophrenia, major depression, or bipolar disorder
• Lifetime history of psychiatric hospitalization because of any mental illness Mental illness, other than depression, that needed psychological or pharmacological treatment in the past
• Any neurodevelopmental or neurodegenerative disease, or stroke or positive findings on past head CT or brain MRI
• Pregnancy
• Hamilton Rating Scale for Depression (HRSD-17) is more than 7
• MRI contraindications