< 30 treatments and 60.9% with  30 treatments). There were no serious adverse events, but some patients experienced transient mild to moderate headaches. Conclusions: dTMS with the H7 coil in a naturalistic setting is efficacious for OCD. Disclosure: Aron Tendler, Mark Deluca, and Noelia Rodriguez have finan- cial interest in Brainsway, the manufacturer of the deep TMS system. Ro- man Gersner is an employee of Brainsway. DEEP-TMS FOR ADHD: A RANDOMIZED SHAM CONTROLLED FMRI STUDY Tal Harmelech 2 , Maya Bleich-Cohen 1 , Abraham Zangen 1 , Talma Hendler 1 , Elissa Ash 1 , Aron Tendler 2 . 1 Ben Gurion University of the Negev, USA; 2 Brainsway Ltd., USA Objective: Present preliminary results of a blinded sham-controlled re- petitive deep TMS(dTMS) study of ADHD with fMRI. Introduction: The cingulo-frontal-parietal brain network controls goal- directed processes and provides the ability to respond to changing atten- tional task demands. Within this network, hypoactivity of the dorsolateral prefrontal cortex (DLPFC) has been observed in patients with ADHD. High- frequency dTMS increases cortical excitability that outlasts the period of stimulation. The current study examines the efficiency of dTMS in adults with ADHD using fMRI. Methods: Adults with ADHD were randomized to receive right, left or sham DLPFC dTMS after cognitive training for fifteen treatments over 3 weeks. Clinical effects were assessed with a standard-symptoms scale (CAARS) and a cognitive assessment battery (Mindstreams) at 3 time- points: prior to participation (SCR), after the treatment phase (V15) and 1 month post-treatment (V16). Neurophysiological effects were assessed with fMRI using an N-back task with different levels of working memory (WM) demand before and after the treatment phase. Results: 39 subjects received dTMS; 34 completed the treatment phase and were included in the current analysis. Significant improvements were observed in CAARS inattention sub-scale and in the attention and execu- tive function scores on the Mindstreams battery in the real stimulation groups mainly in the right DLPFC group. In the fMRI, there was a significant increased activation in the right DLPFC during the WM task after 3 weeks of dTMS. Conclusions: Results of this ongoing study indicate that dTMS is an effi- cient tool to modulate attention related brain networks and treat ADHD. Disclosures: Dr. Tendler and Dr. Zangen have a financial interest in Brainsway, the manufacturer of the dTMS coils. Dr. Harmelech is an employee of Brainsway. MODULATION OF CORTICOMOTOR EXCITABILITY FOLLOWING 10 HZ REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION PREDICTS CLINICAL RESPONSE IN PATIENTS WITH TREATMENT-RESISTANT DEPRESSION Carrie A. Hinchman, Peter J. Fried, Alvaro Pascual-Leone, Daniel Z. Press, Adam P. Stern. Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA Objective: Investigate if modulation of corticomotor excitability by transcranial magnetic stimulation (TMS) predicts response to TMS treat- ment for depression. Secondary aims compared the modulation of excit- ability between conventional 10Hz repetitive TMS (rTMS) and intermittent theta burst stimulation (iTBS), and between depression patients and demographically-similar controls. Background: Approximately 50-60% of depression patients respond to the standard rTMS treatment. Establishing predictors of response would be beneficial clinically. Design/Methods: Ten patients with treatment-resistant depression and four healthy controls completed two neuromodulation visits. In all sub- jects, the impact of stimulation type (10Hz, iTBS) was assessed by the change in motor evoked potential (MEP) amplitude. Patients subsequently underwent a standard rTMS induction, assessed by the Hamilton Depression Scale (HAM-D) and Beck Depression Inventory (BDI). The percent change (%D) of MEPs was related to %D in HAM-D and BDI scores in patients, and compared across the two stimulation types in both groups. Results: Across all patients, there was a moderate, but non-significant negative correlation between %D in MEPs following 10Hz and %D in depression scores (HAM-D: R[8]¼-0.21, p¼0.556; BDI: R[8]¼-0.24, p¼0.501), indicating better treatment response in those with greater MEP modulation. By removing one outlier (a patient who showed robust modulation, but poor response to treatment), the correlations became significant for both (HAM-D: R[7]¼-0.67, p¼0.048; BDI: R[7]¼-0.83, p¼0.006). Across all subjects, modulation of MEPs was greater following 10Hz than iTBS (p¼0.016). No significant differences were observed be- tween patients and controls (p’s > 0.05). Conclusions: Neuromodulation of corticomotor excitability by 10Hz rTMS may predict subsequent treatment response. BIPOLAR, DEPRESSED, AND PREGNANT e TRANSCRANIAL MAGNETIC STIMULATION AS A TREATMENT ALTERNATIVE Debra J. Stultz 1, * , Dan Thistlethwaite 2 , Russ Voltin 2 , Savanna Osburn 1 , Robin Walton 1 , Tyler Burns 1 . 1 Stultz Sleep & Behavioral Health, 6171 Childers Road, Barboursville, WV 25504, USA; 2 PsyCare, 312 6th Avenue, Suite 2, South Charleston, WV 25303, USA * Corresponding author. Bipolar, depressed, and pregnant e TMS as a treatment alternative: Debra J. Stultz M.D., Dan Thistlethwaite M.D., Russ Voltin M.D., Savanna Osburn, B.S., Robin Walton EdD, MSN, APRN-FNP, and Tyler Burns, MA, LPC, AADC, NCC Background: The patient was a 31 year old pregnant white female who had previously been diagnosed with Bipolar Disorder and treated with multiple psychotropic medications. She was actively participating in psy- chotherapy and was already on Abilify 30 mg q da, Zoloft 100 mg qd, Buspar 10 mg BID and Provigil 200 mg qd. (She was being followed by both the high risk pregnancy clinic in our area and the Cleveland Clinic.) As her pregnancy progressed she had increasing symptoms of depression, weight loss, and significant GI complaints. At 25 weeks gestation she began TMS treatment. Method of Treatment: After discussing the risks/benefits of TMS, treat- ment was initiated using the Brainsway H1 coil. The patient completed a Beck Depression Inventory and a PHQ-9 questionnaire at the beginning and at the end of treatment. She received 25 treatments. Results: Her Beck Depression Inventory decreased from 22 to 6. Her PHQ-9 score dropped from 18 to 3. She experienced no complications with the TMS and had no manic Symptomatology. Her depression improved and her mood stabilized. We were able to decrease medications during the TMS. She did very well, until her baby was delivered at 33 weeks gestation by C-section due to placenta abruption. This was not felt to be related to the TMS treatment. Her baby had a brief NICU stay for feeding issues, but then returned home with the patient without complications. Conclusions: The patient had clinically significant improvement in her mood without the need for additional psychotropic medication during her pregnancy. EEG FEATURES FOLLOWING SINGLE PULSES OF DEEP TMS AS BIOMARKERS FOR TREATMENT OUTCOME IN MAJOR DEPRESSIVE DISORDER Roie Cohen 1 , Gaby Pell 1 , Yiftach Roth 1 , Aron Tendler 1, 2 , Abraham Zangen 3 . 1 Brainsway LTD, USA; 2 Advanced Mental Health Care Inc., USA; 3 BGU, USA Background: TMS-EEG is a rapidly growing area which can be used to assess cortical activity in response to TMS pulses with high temporal resolution. Abstracts / Brain Stimulation 11 (2018) e9ee21 e15