Exercise to Augment TMS in Those With Treatment Resistant Depression

Given the growing evidence that aerobic increases cortical excitability and promotes neuroplasticity, the scientific premise for its potential priming effect on the brain is strong. Combining AE with rTMS may produce a neural environment optimized for a robust physiological effect of rTMS, thereby leading to improved depression outcomes. With positive findings, this study would provide preliminary support for an innovative, safe and feasible approach for improving outcomes for this significant public health problem.

Inclusion Criteria: * adult outpatients (age 18 and above) who are already approved to receive standard TMS therapy through the Butler Hospital TMS clinic. * able to safely engage in moderate-intensity aerobic exercise (determined by a study physician) Exclusion Criteria: * Currently pregnant or plans to become pregnant in the next 6 weeks