THE CLINICAL TMS SOCIETY ABSTRACTS 1 MDDScore and Biomarker Profiling in Patients Treated with Transcranial Magnetic Stimulation: Preliminary Data John A. Bilello a , Linda M. Thurmond a , Sandeep Vaishnavi b,c , Kevin M. Kinback d a Ridge Diagnostics Inc., Research Triangle Park NC b The Neuropsychiatric Clinic at Carolina Partners, Raleigh, NC c Department of Community and Family Medicine, Duke University Medical Center, Durham, NC d Advanced TMS Center, Mission Viejo CA Background: A biomarker panel consisting of 9 biomarkers asso- ciated with the neurotrophic, metabolic, inflammatory, and the HPA axis pathways was developed as an aid to MDD diagnosis. The MDDScore panel and algorithm has good sensitivity and specificity in differentiating MDD patients from normal subjects (Papakostas et al Mol. Psych. 2013). It is not clear if treatment-resistant patients with depression will have the same biomarker expression pattern as sensitive patients. We explored this issue by measuring bio- markers in a TMS cohort, as these patients were treatment-resistant in terms of pharmacotherapy and hence were candidates for neuromodulation. Methods: Serum levels of 9 biomarkers (Alpha-1 Antitrypsin, Apolipoprotein CIII, BDNF, Cortisol, EGF, Myeloperoxidase, Prolac- tin, Resistin, and sTNFRII) were determined by immunoassay. MDDScores were obtained using a proprietary algorithm. Pathway- specific coefficients were used to perform 3D-hyperspace mapping of individual patients. Results: Analysis of 11 patients indicated that 9 had MDDScores of 1, usually indicative of a low probability of MDD. The remaining 2 patients had MDDScores of 8 and 9, indicative of a high probability of MDD. 3D-hyperspace mapping (right) indicated that the TMS patients had different patterns of pathway expression than a series of non-treatment resistant MDD patients. Conclusions: Our initial results indicate that the majority of candidates for TMS therapy in our cohort appear to have low MDDScores and a different biomarker expression pattern than non- treatment resistant MDD patients. It is not clear whether the dif- ferences are due to treatment-resistance per se, or to biochemical alterations in a cohort of extensively treated depressed patients. 2 Treatment of Unipolar, Non-Psychotic Major Depressive Disorder with Transcranial Magnetic Stimulation: Results from a Retrospective Evaluation of Measured Outcomes during Routine Clinical Practice Kimberly Cress M.D. TMS Serenity Center, Sugar Land, Texas Background: Major Depressive Disorder (MDD) affects approxi- mately 14.8 million lives in the U.S. (6.7% of Adults) with about 50% seeking help and only 20% receive adequate treatment. Transcranial Magnetic Stimulation (TMS) is noninvasive, non-systemic therapy that uses pulsed magnetic fields to induce an electric current in the brain that results in localized neuronal depolarization and benefi- cial effects on the symptoms of MDD. The purpose of this study is to evaluate the standardized symptom score outcomes in routine clinical practice. Methods: 101 patients with a primary diagnosis of unipolar MDD who had not received benefit from antidepressant treatment received TMS treatment. Patients were assessed using the Beck Depression Inventory scale, Patient Health Questionnaire depres- sion scale and the Beck Anxiety Inventory scale. Scores were per- formed prior and at the end of the acute treatment phase. Long- term follow-up was reported on those patients that returned for assessment. Results: The study average age was 46.6 years. The mean TMS sessions were 36.6+/-13.4 with a range of 3,000 to 4,600 pulses administered daily. 78 (77.2%) patients demonstrated a minimum 50% improvement in the BDI symptom score while 63 patients (62.4%) reported symptom scores < 10. Total mean baseline BDI score was 25.0 and improved to a mean 9.6 at the end of treatment. Forty (40) patients were followed for a year or more with 29 (72.5%) remaining in remission. PHQ-9 and BAI results demonstrated similar efficacy. Conclusion: In routine clinical practice TMS shows significant im- provements in symptom scores with a durable long-term outcome 3 Assessment of TMS interference on MRI and MEG acquisition Dominique Crosby b , Geoffrey Grammer a , Mihai Popescu a , Wei Liu a , Anda Popescu a a National Intrepid Center of Excellence (NICoE) b Walter Reed National Military Medical Center, Bethesda, MD Contents lists available at ScienceDirect Brain Stimulation journal homepage: www.brainstimjrnl.com 1935-861X/$ e see front matter Ó 2014 Published by Elsevier Inc Brain Stimulation 7 (2014) e17ee26