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TMS for Alzheimer's and Cognitive Decline
An emerging, non-invasive option being studied to slow decline and support memory. Explained honestly, including what it cannot do.
A dementia diagnosis often comes with a quiet message that there is nothing left to try. Medications help some people for a while. Then the conversation tends to stop. We want to give you a fuller picture. Transcranial magnetic stimulation is being studied right now in Alzheimer’s disease and mild cognitive impairment, and some of the recent results are worth paying attention to. It is also early, and it has real limits. We will walk you through both, and we will never tell you it is something it isn’t.
Talk to a clinician.
See the research
Talk to a clinician.
See the research

What TMS can and cannot do for dementia

TMS is not a cure for Alzheimer’s or any other dementia. It does not clear away the proteins behind the disease. It does not reverse damage that has already happened, and it cannot bring back memories or abilities that are already gone. Any clinic that tells you otherwise is not being straight with you.

What the research does suggest is smaller and more realistic. In some people with mild to moderate Alzheimer’s, certain TMS protocols may slow how fast cognition and daily function decline over a course of treatment. TMS may also help with symptoms that often travel with dementia, especially depression, low mood, and apathy. Those are real goals. They are not the same as a cure.

TMS is FDA-cleared for major depression and for OCD. It is not FDA-cleared for Alzheimer’s or dementia. Using it for cognitive decline is considered investigational. That is exactly how we offer it: as an evidence-informed option to talk through, not a guaranteed treatment.

What is happening in the brain with Alzheimer's and MCI

Alzheimer’s is driven by changes in the brain, the buildup of amyloid and tau proteins, that damage and disconnect neurons over time. But the symptoms people notice early on are also a story about brain networks losing their connections.

One of the first regions affected is a hub called the precuneus. It sits at the center of the network the brain uses for memory and for pulling information together. As Alzheimer’s moves forward, the precuneus and the circuits tied to it have a harder time communicating. The brain’s ability to form and strengthen connections, called plasticity, drops off.

TMS does not change the proteins behind the disease. It works on a different layer: the activity and connectivity of the brain circuits that are still working. Focused magnetic pulses are used to raise activity and strengthen connections in those circuits while they are still healthy enough to respond. This is also why timing matters in the research. Earlier in the disease, there is more for TMS to work with.

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We don't ask you to trust us. We show you the research.

The precuneus protocol, the most promising recent data

A series of randomized, placebo-controlled trials led by Dr. Giacomo Koch targeted the precuneus in patients with mild to moderate Alzheimer’s. In a 24-week trial of 50 patients, published in the journal Brain in 2022, the patients who got real precuneus stimulation held steady on a standard dementia rating scale while the placebo group declined. They also did better on tests of memory, thinking, and daily function. A follow-up 52-week trial of 48 patients, published in Alzheimer’s Research and Therapy in 2025, hit its main goal and showed about 44 percent slower decline than placebo, along with better daily-living and cognitive scores. This protocol is now moving into larger studies.

The largest review to date

In 2024, researchers at Mayo Clinic and Harvard pooled 143 studies and about 5,800 patients, with a focused analysis of 25 randomized trials in MCI and Alzheimer’s. Across those trials, TMS beat placebo on every standard measure of thinking, with large statistical effects. The researchers were just as clear about the caveats. The studies varied a lot, and a large effect on a test does not always mean a change a family would notice at home. As they put it, in dementia even a small gain can matter. This is a promising field, not a finished one.

The most-studied target, and the faster version of TMS

The single most common target in the research is the left prefrontal cortex, the same region used in FDA-cleared TMS for depression. A newer, faster form called intermittent theta-burst stimulation, or iTBS, delivers a similar dose in a fraction of the time. In a 2025 randomized trial of 52 people with mild memory loss or very early Alzheimer’s, ten sessions of prefrontal iTBS over two weeks led to real cognitive gains by week six. The delay fits how TMS works. The brain rewires gradually, so the benefit shows up later, not the same day. Because this region also lifts mood, part of the benefit in some studies may come from easing depression. For a patient who has both dementia and depression, that is a plus, not a problem.

Where the FDA stands

A combined system that paired TMS with computer-based brain training, called NeuroAD, went in front of an FDA advisory panel. The panel found it safe but voted that it had not been shown to work for Alzheimer’s. It is approved in parts of Europe, in Australia, and in Israel, but it is not FDA-cleared here. We tell you this because it is true, and because it frames what we offer. This is an investigational use, backed by real but unfinished evidence.

A one-day approach, and why that matters for caregivers

For an older adult with memory loss, the schedule is often the hardest part. Daily clinic visits for weeks, then ongoing upkeep, can be a lot when a patient depends on a spouse or an adult child for every ride. A treatment that isn’t realistic is a treatment that doesn’t help.

Closing that gap is the whole idea behind our One-Day Intensive, and the early research is starting to point the same way. A 2024 case report tested a single-day protocol in Alzheimer’s patients. Each treatment day paired a dose of D-cycloserine, a medication that boosts neuroplasticity, with a series of short iTBS sessions aimed at the precuneus, repeated just once a month for five months. Both patients, ages 78 and 83 and new to TMS, improved on standard memory and thinking tests, and the gains mostly held across the follow-up months. It is the same set of ideas behind our accelerated work. Shorten the schedule, add a medication that helps the brain change, and make treatment something families can actually do.

Depression (MDD)

Read this as a signal, not a promise.

This was two patients, with no comparison group and no placebo. That is the weakest kind of evidence. It cannot tell us how much of the change came from the treatment versus chance or normal ups and downs. We share it because it suggests a faster, caregiver-friendly approach may be workable and worth studying, not because it proves the approach works. The authors say controlled trials are needed. We agree.

PTSD

Want to talk through whether a one-day approach fits?

There is no one-size-fits-all approach to dementia treatment, but that doesn’t mean there’s no hope. What we can do is sit down with you, look at the diagnosis and the stage, walk through what the research does and does not support, and tell you honestly whether an accelerated approach is worth considering for your family.

Free consultation

Curious how a full course of TMS fits into a single clinic day? See how our One-Day Intensive works.

Where TMS may help?

TMS is studied for two different goals in dementia.

Memory and thinking (slowing the slide)

In the trials above, the goal is not to bring back lost memory. It is to slow how fast memory, attention, language, and daily function decline. The benefit shows up most in mild to moderate disease. Earlier treatment appears to matter more.

Mood and behavior (firmer ground)

Depression, apathy, anxiety, and poor sleep are common in dementia, and they hit quality of life hard for patients and families. TMS is FDA-cleared and well established for depression, including in older adults, and early evidence suggests it may help with the mood and behavior symptoms that come with dementia. For a lot of families, better mood, more engagement, and better sleep is a real win on its own.

Is TMS worth a conversation for your situation?

It may be worth talking about if:

  • You or a loved one has mild cognitive impairment or mild to moderate Alzheimer's. These earlier stages have the strongest evidence.
  • You want something to add to current care, not a replacement for medication or other treatment.
  • Depression, apathy, or low mood are part of the picture.
  • You understand this is an investigational use and want an honest read on whether it could help.
  • The patient can sit for treatment sessions and follow simple instructions.
It is probably not the right fit if:
  • The patient has advanced dementia. The current evidence does not support a benefit at that stage.
  • There is metal in or near the head, a history of seizures or epilepsy, or certain other neurological risks.
  • You are looking for a cure, or expecting lost abilities to come back.
  • The patient cannot tolerate the treatment setting.

Note: A licensed clinician decides eligibility after a full review. The consultation is where we figure out, honestly, whether this makes sense for your family.

Free Consultation

What treatment looks like?

TMS is non-invasive. There is no anesthesia, no sedation, and no hospital stay. The patient sits in a chair while a device near the head sends brief magnetic pulses. Most people feel a light tapping on the scalp. Sessions are usually followed by a normal day. Research protocols for Alzheimer’s tend to start with a short, intensive phase of daily sessions, followed by lighter maintenance sessions spread over months. The point is to support brain networks over time, not to deliver a one-time fix. Any plan we discuss is built around the individual patient, together with you and the patient’s existing care team.
Note on results: When benefits happen, they tend to be gradual and modest, and they vary from person to person. The honest framing is slower decline and better day-to-day function and mood, not a dramatic turnaround. We track progress with standard tests and tell you plainly how it is going.
Treatments

Is TMS safe for older adults?

TMS has a strong safety record across more than twenty years of use, including in older adults. The most common side effects are mild scalp discomfort or a short headache around the time of a session, and they usually pass. There are none of the body-wide drug effects that medications can bring, no sedation, no weight gain, no drug interactions of that kind.


The most serious risk is a seizure, which is very rare, estimated at well under 1 in 30,000 sessions. In the 143-study Mayo and Harvard review, only two studies reported any seizures at all, and most were judged unrelated to the treatment. Because seizure risk and certain neurological conditions matter more in older adults, careful screening by a clinician comes first. That is what the consultation is for.

Start with an honest conversation

No pressure and no commitment. Just a clear look at whether TMS makes sense for your situation, what it could and could not do, and what else is worth considering. If it is not a fit, we will tell you.
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Conroe, TX & Casper, WY

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Frequently Asked Question

Can TMS cure Alzheimer's or dementia?
No. TMS cannot cure Alzheimer’s or any dementia, cannot reverse the disease, and cannot bring back abilities that are already lost. The realistic goals in the research are slowing decline in some patients and helping with related symptoms like depression and low mood.
No. TMS is FDA-cleared for major depression and OCD, not for Alzheimer’s or dementia. Using it for cognitive decline is investigational. We are upfront about that and offer it as an evidence-informed option, not a guarantee.
The most encouraging data, from randomized trials targeting the precuneus, suggests TMS may slow decline in mild to moderate Alzheimer’s. The largest review to date, 143 studies, found real cognitive benefits over placebo. But results vary, and a gain on a test does not always mean a change a family would notice. The evidence is promising, not settled, and we won’t overstate it.
No. A small case report paired D-cycloserine with single-day TMS in Alzheimer’s patients and saw encouraging results, but it was only two patients with no comparison group. That is enough to say the approach may be workable and worth studying, not enough to say it works. We keep that distinction clear.
Because TMS is not FDA-cleared for dementia, it is usually not covered for that use. TMS for depression is often covered. We will explain the cost and coverage picture plainly at your consultation.
The research points to earlier stages, mild cognitive impairment and mild to moderate Alzheimer’s, where more of the brain’s circuitry is still intact. There is little evidence of benefit in advanced dementia.
Generally yes, with proper screening. TMS is non-invasive, needs no anesthesia, and the main side effects are mild and short-lived. The rare serious risk is a seizure, which screening helps prevent. A clinician checks suitability before any treatment.
In most cases yes. TMS is studied as an add-on to standard care, not a replacement. We coordinate with the patient’s existing providers.

Sources

  1. Koch G, et al. Precuneus magnetic stimulation for Alzheimer’s disease: a randomized, sham-controlled trial. Brain. 2022;145(11):3776-3786.

   https://academic.oup.com/brain/article/145/11/3776/6701823

  1. Koch G, et al. Effects of 52 weeks of precuneus rTMS in Alzheimer’s disease patients: a randomized trial. Alzheimer’s Research and Therapy. 2025.

   https://pmc.ncbi.nlm.nih.gov/articles/PMC11963669/

  1. Pagali SR, et al. Efficacy and safety of TMS on cognition in mild cognitive impairment, Alzheimer disease, and related dementias: a systematic review and meta-analysis. International Psychogeriatrics. 2024;36(10):880-928.

   https://pmc.ncbi.nlm.nih.gov/articles/PMC11306417/

  1. Law A, et al. Single-day TMS regimens in Alzheimer’s and frontotemporal dementia: two cases (ONE-AD). Transcranial Magnetic Stimulation. 2026;7(Suppl 1):100271.

   (Case series of 2 patients; preliminary and uncontrolled.)

   https://doi.org/10.1016/j.transm.2026.100271

  1. Yang C, et al. Effects of intermittent theta-burst stimulation on cognition and glymphatic system activity in mild cognitive impairment and very mild Alzheimer’s disease: a randomized controlled trial. Journal of NeuroEngineering and Rehabilitation. 2025.

   (RCT, 52 patients; cognitive gains by week 6.)

   https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-025-01738-1

  1. NeuroAD (TMS combined with cognitive training). ALZFORUM Therapeutics database.

   (FDA advisory panel: safe, but effectiveness not demonstrated; not FDA-cleared in the U.S.)

   https://www.alzforum.org/therapeutics/neuroad

  1. Zhou Y, et al. The repetitive transcranial magnetic stimulation in Alzheimer’s disease patients with behavioral and psychological symptoms of dementia: a case report. BMC Psychiatry. 2023;23(1):354.

   https://link.springer.com/article/10.1186/s12888-023-04864-z

  1. Cappon D, et al. Transcranial magnetic stimulation (TMS) for geriatric depression. Ageing Research Reviews. 2022;74:101531.

   https://pmc.ncbi.nlm.nih.gov/articles/PMC8996329/