Optimizing Brain Excitability in Depression

Optimized Methods for Measuring Brain Excitability in Depression

The goal of this study is to improve depression treatment by establishing reliable prefrontal excitability markers through Targeting with Automated Real-time Guidance for Enhancing TEPs (TARGET).

Inclusion Criteria:

• Men and women, ages 18 to 65
• Diagnosis of major depressive disorder, assessed through a Structured Clinical Interview for DSM-5 (SCID-5)
• In a current depressive episode, assessed through a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (SCID-5)
• Moderate-to-severe depression as indicated by a score between 11-20 on the Quick Inventory of Depressive Symptoms (QIDS)
• Must comprehend English well to ensure adequate comprehension of the EEG and TMS instructions, and of clinical scales
• No current or history of neurological disorders
• No seizure disorder or risk of seizures
• Neurosurgical patients: Men and women ages 18-65 with medication-refractory epilepsy who are admitted for phase II intracranial monitoring to detect a seizure focus will be considered appropriate for this study. Participants must have the intellectual capacity to understand the consent process and agree to the study.

Exclusion Criteria:

• Those with a contraindication for MRIs (e.g. implanted metal)
• History of head trauma with loss of consciousness
• History of seizures or on medications that reduce seizure threshold (e.g., olanzapine, chlorpromazine, lithium)
• Neurological or uncontrolled medical disease
• Any unstable medical condition
• Active substance abuse
• Diagnosis of psychotic or bipolar disorder
• A prior history of Electroconvulsive Therapy (ECT) failure
• History of suicide attempt in the past year
• Currently pregnant or breastfeeding
• Repetitive Transcranial Magnetic Stimulation (rTMS) treatment in the past six months