Network-targeted transcranial magnetic stimulation (TMS) for mild cognitive impairment (MCI)

Joy L Taylor ¹, Priyanka Bhatt ², Beatriz Hernandez ³

¹Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), US Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA 94305, USA. Electronic address: joyt@stanford.edu.
²Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), US Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA 94304, USA.
³Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), US Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA 94305, USA.
⁴Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Stanford, CA 94305, USA.
⁵Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Department of Neurosurgery, Stanford University, School of Medicine, Stanford, CA 94305, USA.
⁶Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), US Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA 94305, USA. Electronic address: windymc@stanford.edu.

⁰Sierra-Pacific Mental Illness Research Education Clinical Center (MIRECC), US Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA 94305, USA. Electronic address: joyt@stanford.edu.

Neuroimage. Clinical +

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June 13, 2025

View abstract on PubMed

Summary

This study investigated optimal brain stimulation sites for mild cognitive impairment (MCI) and Alzheimer's disease (AD) using transcranial magnetic stimulation (TMS). Findings reveal specific prefrontal and parietal targets for improved cognitive function and personalized treatment.

Area Of Science

Neuroscience
Cognitive Science
Medical Imaging

Background

Transcranial magnetic stimulation (TMS) shows promise for treating mild cognitive impairment (MCI) and early Alzheimer's disease (AD).
Optimal stimulation locations for cognitive enhancement via TMS remain largely unknown.
Prefrontal and parietal regions are key targets in prior TMS studies for MCI-AD and healthy cognition.

Purpose Of The Study

To analyze network functional connectivity (fc) of prefrontal and parietal TMS sites.
To determine ideal stimulation targets for improving cognitive function in MCI-AD patients.
To explore personalized TMS treatment strategies based on network connectivity.

Main Methods

Resting-state functional MRI data from 32 MCI participants were analyzed.
Connectivity was computed for prefrontal and parietal stimulation sites identified from prior TMS research.
TMS seed maps were assessed for overlap with canonical brain networks, and strategies for purer targeting were applied.

Main Results

The prefrontal TMS site primarily targeted the salience network and showed anti-correlated connectivity with the posterior cingulate cortex (PCC).
The parietal TMS site connected strongly with the PCC and default mode network regions, potentially also modulating the fronto-parietal network.
Secondary findings detail methods for enhanced network targeting and personalized TMS.

Conclusions

Results inform network-targeted brain stimulation for MCI and early AD.
Precise and personalized TMS approaches hold potential for improved patient outcomes.
This research supports the development of more effective, individualized TMS therapies for cognitive decline.

Keywords:

Alzheimer’s disease Functional connectivity Mild cognitive impairment Network neuroscience Transcranial magnetic stimulation fMRI

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