Could magnetic pulses boost memory in Alzheimer's? new pilot study aims to find out

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Agreement to participate in study and able to complete informed consent process * Have a caregiver or study partner who can accompany them to all study visits * Have a known alternate surrogate decision-maker (in case needed) who can be present for informed consent * Established diagnosis of biomarker-positive (amyloid-PET, plasma or CSF amyloid ratio or phosphorylated tau) mild-moderate (clinical stages 3, 4, and 5) Alzheimer's Disease based on the 2024 Alzheimer's Association Framework * Age 55-100 at the start of the study. * Screening MOCA 12-25 (\< 26, \> 11) * Screening GDS score \<6 * Either 1) treated with memory-enhancing medication (cholinesterase inhibitor or other medications or treatments) for at least 2 months, 2) failed trial with no plan to re-trial, or 3) no trial planned during the course of the study for other reasons * No change in use of psychotropic medication (or other treatments) for the treatment of depression, anxiety, ADHD, or psychosis for 2 weeks prior to the study Exclusion Criteria: * Unwilling or unable to provide informed consent as outlined below * Currently pregnant or potentially pregnant * Diagnosis of a dementia or cognitive disorder primarily or exclusively due to a cause other than Alzheimer's Disease * Diagnosis of severe Dementia (CDR \> 2.0/ AA clinical stage 6) at the start of the study * History of substance use disorder currently not in sustained remission * Substance misuse within the past 6 months (excluding nicotine or caffeine) * History of stroke, traumatic brain injury with loss of consciousness, or other major neurologic disorder (e.g., epilepsy, Huntington's disease, Parkinson's disease) * History of seizure disorder or family history of seizure disorder in a first-degree relative * Poorly-controlled hypertension, cardiovascular disease, or cerebrovascular disease * History of any other major active medical, neurologic, or psychiatric illness affecting cognition (associated with cognitive impairment) or a participant's ability to safely and meaningfully participate in the study * Non-fluent in English (not native or functionally-native, specified here for cognitive testing purposes) * Contraindication to TMS or MRI including claustrophobia, MRI-incompatible or unknown metal in body (including facial tattoos with uknown or metallic inks), surgery within 60 days, certain implants (excluding dental fillings), or previous abnormal MRI results unrelated to a potential participant's dementia. * For the randomized stage only-has a history of prior TMS treatment (not TMS naïve) * Currently enrolled in an interventional memory-enhancement study * Alteration in cognitive-enhancement medication (or other treatment) dose within the past 2 months or active plans for dose alteration during the course of the study (previously unplanned changes that occur during the study will be examined on a case-by-case basis) * Has started treatment with lecanemab, donanemab, or any other monoclonal antibody for Alzheimer's Disease within the past 6 months OR has a history of treatment complicated by amyloid-related imaging abnormalities (ARIA) * Currently or within the past 2 weeks taking any of the following classes of medication: * Anticholinergic (e.g., tolterodine, benztropine) * Sedating antihistamines (e.g., diphenhydramine) * any drug that has significant anticholinergic or antihistaminic side effects (e.g., tricyclic antidepressant medications, mirtazapine). * Benzodiazepines. While not a strict rule out, this will be decided on a case-by-case basis * Opioid. While not a strict rule out, this will be decided on a case-by-case basis * Antiepileptic agents. While not a strict rule out, this will be decided on a case-by-case basis * Antipsychotic agents. While not a strict rule out, this will be decided on a case-by-case basis