Virtual Neuro-Navigation System for Personalized Community Based TMS

Exclusion Criteria

• •Ever met criteria for a psychotic disorder (Sz, SzAff, Bipolar disorder), anorexia nervosa or bulimia nervosa within the last year
• •Unstable medical condition by history, physical exam or laboratory results
• •Currently pregnant or breastfeeding women; fecund women not using adequate contraceptive methods or with plan to become pregnant
• •Contraindications to MRI (based on metal screening form)
• •Meets criteria for claustrophobia
• •Recent drug or alcohol use disorder with DSM-5 specifier of moderate or severe within 6 months, or mild within 2 months; lifetime history of IV drug use
• •Actively suicidal, as defined by expressive ideation with a plan or with suicidal ideation that requires immediate medical or treatment intervention.
• •A neurological or neuromuscular disorder
• •Requires medications for a general medical condition that contraindicate the TMS treatment
• •Prior non-response to ECT, vagal nerve stimulation (VNS) or deep brain stimulation (DBS)
• •History of ketamine treatment within 6 mo
• •History of monoamine oxidase inhibitor (MAOI) within the past month
• •Lacks capacity to consent
• •Taking medications that increase the risk of seizures.
• •For patients on permitted concomitant psychotropic agents (antidepressants, anticonvulsants, benzodiazepines, hypnotics, opiates, triiodothyronine (T3), modafinil, psychostimulants, buspirone, melatonin, omega-3 fatty acids, folate, l-methylfolate, s-adenosyl methionine, lithium) dosing must be stable for at least four weeks prior to study entry and patients must agree to continue at the same dose during the study