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\section{Background}  The antidepressant efficacy of recurrent transcranial magnetic stimulation (rTMS) has been supported by a growing number of clinical trials\cite{8547583,20439832,22579164}, leading to its FDA approval for major depressive disorder in 2008\cite{George_2013}. More recent studies have demonstrated that differential treatment parameters are effective for patients with varying degrees of treatment resistance\cite{8684201,16390894,McGirr_2015}. When rTMS is effective, its antidepressant results have been demonstrated to persist well beyond the initial treatment course\cite{22689290}. However, its utility is somewhat limited by the fact that not all studies have found positive results, although this has been associated with methodological variability; as a result, more recent treatment protocols have found better results than older studies\cite{17655557}.  A major limitation to the widespread use of rTMS is the fact that it is difficult to predict which patients will improve, thereby necessitating significant financial investment despite uncertainty regarding potential efficacy for any given patient. As a result, such predictive factors have been investigated thoroughly. Baseline clinical characteristics associated with improved response rates include concurrent antidepressant pharmacotherapy\cite{22980479}, fewer prior treatment failures, shorter duration of the current episode, and lack of a baseline anxiety disorder\cite{18704101}. Impaired response is associated with the converses of these factors as well as benzodiazepine or anticonvulsant pharmacotherapy\cite{22980479}. Response in older patients is improved when using increased doses in order to overcome the higher coil-to-cortex distance caused by cerebral atrophy in these populations\cite{15274174}. Several biomarkers have also been identified to predict some degree of treatment response, including electroencephalographic parameters\cite{22410477}, anterior cingulate cortex activity\cite{17984932,Micoulaud_Franchi_2013}, prefrontal cortex activity\cite{Kito_2012,Micoulaud_Franchi_2013}, motor cortex excitability\cite{Fitzgerald_2004},