Accelerated Intermittent Theta-Burst Stimulation (aiTBS) in Treatment-Resistant Depression of Bipolar II Disorder

Exclusion Criteria

• •1. Primary diagnosis other than bipolar II disorder
• •2. Any structural lesion e.g. structural neurological condition, more subcortical lesions than would be expected for age, stroke effecting stimulated area or connected areas or any other clinically significant abnormality that might affect safety, study participation, or confound interpretation of study results.
• •3. Metal implant in brain (e.g. deep brain stimulation), cardiac pacemaker, or cochlear implants
• •4. History of epilepsy or seizures
• •5. Shrapnel or any ferromagnetic item in the head
• •6. Pregnancy
• •7. Autism Spectrum disorder
• •8. Any current or past history of any physical condition which in the investigator's opinion might put the subject at risk or interfere with study results interpretation
• •9. Active substance abuse (\<1 week) or intoxication verified by toxicology screen--of cocaine, amphetamines, benzodiazepines
• •10. Cognitive impairment (including dementia)
• •11. Current severe insomnia (must sleep a minimum of 5 hours the night before stimulation)
• •12. Current hypomania or psychosis
• •13. Showing symptoms of withdrawal from alcohol or benzodiazepines
• •14. A diagnosis of intellectual disability
• •15. Parkinsonism or other movement disorder determined by Principal Investigator to interfere with treatment
• •16. Any other indication the Principal Investigator feels would comprise data.
• •17. Current active suicidal ideation or suicide attempt or suicidal behaviors in the last 6 months
• •18. Any history of psycho surgery for depression
• •19. Any history of ECT (greater than 8 sessions) without meeting responder criteria
• •20. Recent (within 4 weeks of any clinical effect) or concurrent use of rapid acting antidepressant agent (i.e., ketamine or a course of ECT)
• •22\. Any history of myocardial infarction, CABG, CHF, or other cardiac history
• •23\. The presence or diagnosis of prominent anxiety disorder, personality disorder or dysthymia
• •24\. History of intractable migraine
• •25\. Hypomania in the past 6 months.
• •26\. Depth-adjusted aiTBS treatment dose \> 65% maximum stimulator output (MSO)
• •27\. Unstable symptoms between screening and baseline as defined by a 30% change in MADRS-C score.
• •28\. Any other condition deemed by the PI to interfere with the study or increase risk to the participant