Repetitive Transcranial Magnetic Stimulation for Treating Depression: A Functional Magnetic Resonance Imaging Study

Exclusion Criteria

• •DIAGNOSTIC EXCLUSIONS:
• •Co-morbid psychiatric diagnosis of bipolar disorder, acute OCD, schizophrenia or schizoaffective or concurrent treatment with outpatient ECT, or personality disorder or MDD with suicidal ideation as determined by history and/or by P.I. examination requiring hospital admission or referral for acute care.
• •Previous failure to respond to treatment with rTMS
• •Failure to achieve satisfactory improvement in depression after two or more adequate trials of antidepressant medications.
• •MEDICAL EXCLUSIONS:
• •Patients newly diagnosed with thyroid dysfunction
• •History of drug and/or ETOH dependence
• •History of seizures
• •History of head injury with loss of consciousness \> 5 minutes
• •Any implantable metal object in the skull or near their head
• •Any implantable devices such as a cardiac pacemaker, vagal nerve stimulator, etc.
• •Positive urine pregnancy test
• •Severe migraine headaches uncontrolled with routine non-narcotic medication
• •Any medical condition in the opinion of the Investigator that might confound the results of the study Contraindications to fcMRI procedure
• •Intake of NSAIDS, narcotic or muscle relaxants within 72 hours of the fMRI protocol.
• •Claustrophobia.
• •Left-handedness (may influence cerebral cortical hemispheric dominance).
• •Inability to tolerate, or medical contraindication to MRI testing (e.g. metal prostheses or implants, history of claustrophobia)
• •PROTOCOL SPECIFIC EXCLUSIONS:
• •Unable to determine motor threshold for determining treatment dose with rTMS device
• •Mini Mental Status Exam (MMSE)70 score \< 24.