Table 1 Inclusion and Exclusion Criteria

Inclusion Criteria

● Ages 18 years and older

● Meets DSM-5 criteria for MDD (as documented by the TMS physician)

● Meet study criteria for pharmacoresistance in accordance with the Clinical TMS Program (i.e. failed at least one antidepressant in the current episode)

● Ability to obtain a motor threshold (MT) prior to the start of treatment

● Stable medical conditions and ability to maintain stability on current medication regimen for the duration of treatment

● Ability to participate in a daily treatment regimen

● Able to read, verbalize understanding, and voluntarily sign the Informed Consent Form prior to participating in any study-specific procedures or assessments

Exclusion Criteria

● History of seizure disorder

● Structural or neurologic abnormalities present or in close proximity to the treatment site

● History of brain surgery

● Pacemaker or medical infusion device (unless MRI compatible)

● History of traumatic brain injury within 60 days of the start of treatment

● Severe or uncontrolled alcohol or substance use disorders

● Active withdrawal from alcohol or substances

● Implanted device in the head

● Metal in the head

● Severe impediment to vision, hearing and/or hand movement, likely to interfere with ability to complete the assessments, or unable and/or unlikely to follow the study protocols

● Lifetime history of bipolar I disorder

● Inability to speak, read or understand English

● Plans to move out of the area during the study period

● Clinician and/or Investigator discretion for clinical safety or protocol adherence