Treatment of Depression Post-SCI

Eligibility Criteria

• 1. Age 18 - 70;
• 2. At least 6 months post incomplete cervical or incomplete or complete thoracic level SCI;
• 3. Have at least partial active movement of the right thumb (abductor pollicis brevis) to allow for FDA approved rTMS dosing;
• 4. Major depressive disorder, as identified through screening tools;
• 5. No antidepressant medications or no change in doses of psychotropic medication(s) for at least 4 weeks prior to the study (6 weeks if newly initiated medication).
• 1. Concomitant neurologic diseases/disorders or dementia;
• 2. Cognitive impairment, as identified through a screening tool (Montreal Cognitive Assessment);
• 3. History of major head trauma as identified through a screening tool (Ohio State University Traumatic Brain Injury Identification Method);
• 4. History of psychosis or other Axis I disorder that is primary;
• 5. Positive screen for bipolar disorder, as identified through a screening tool (The Mood Disorder Questionnaire);
• 6. Life expectancy \<1 year;
• 7. Attempt of suicide in the last 2 years;
• 8. Electronic or metallic implants (i.e. metal in the head, cochlear implant, or pacemaker);
• 9. History of seizures or currently prescribed anti-seizure medications;
• 10. Taking medication that increases the risk of seizures;
• 11. Pregnancy as identified through a positive pregnancy test;
• 12. Inability or unwillingness of subject or legal guardian/representative to give informed consent.