Ms June, 62, with severe, recurrent MDD, inquires about rTMS efficacy. Studies show 40% pooled response in trials, 31% in clinical settings. A recent analysis identified rapid responders by week 2. Winninge et al found early improvements in initiative, emotional involvement, and overall MADRS-S score predict rTMS response, with longer depressive episodes and previous ECT linked to lower odds of response. Clinical factors and early symptom improvements are key predictors for rTMS efficacy in depression.