We have also conducted a large scale clinical effectiveness trial of LFR-TMS comparing 1 Hz and 2 Hz stimulation to right PFC (CIA 47). This study involved the randomization of 130 patients with treatment resistant major depression to receive right PFC stimulation in a single daily 15 minute train at either 1 or 2 Hz. 2 Hz stimulation was investigated as a potential way of doubling the number of applied stimuli within identical treatment time (to increase the treatment dose and potentially enhance treatment response). Treatment response was equivalent between the 2 groups (62.3 24.0 % change in the 1 Hz group, 64.7 21.0% change in the 2 Hz group over 4 weeks) with no difference in response. This does not support the substitution of 2 Hz as an optimal condition for LFR-TMS.