Mild cognitive impairment (MCI) is a term used by neurologists to describe symptoms such as forgetting names, losing focus, or struggling with simple tasks. While MCI involves subtle changes in memory or thinking that don’t disrupt daily life, it’s often an early sign of Alzheimer’s disease. The good news is that a non-invasive treatment, transcranial magnetic stimulation (TMS), is showing promise for helping people with MCI.
TMS is a non-invasive procedure that uses magnetic fields to stimulate specific parts of the brain. A shape-8 coil is placed on your scalp, sending magnetic pulses to activate brain cells. These pulses induce neuroplasticity in brain neurons, which improves connections between different brain regions and enhances overall brain function. The FDA has cleared TMS for the treatment of anxiety, depression, and OCD. It is currently being studied for MCI due to its ability to target areas involved in memory and cognition.
TMS sessions typically last 20–40 minutes and are performed at least once a week. Most people feel little to no discomfort, with only mild side effects like temporary scalp tingling.
MCI affects brain areas such as the prefrontal and parietal lobes, which are responsible for memory, attention, and problem-solving. In MCI, these areas may not communicate well. TMS aims to improve this by stimulating these regions to enhance their activity and connections.
A key advancement in TMS research for MCI is the use of functional magnetic resonance imaging (fMRI). fMRI enables the mapping of brain networks and the identification of the precise regions that are disrupted in MCI. By using resting-state fMRI, we can observe how different brain regions communicate and identify the most effective targets for TMS.
fMRI helps identify whether the prefrontal cortex (linked to the salience network for attention and executive function) or the parietal cortex (linked to the default network for memory) should be targeted for optimal results.
A key finding was that personalization matters – the study demonstrated that using individual brain connectivity patterns from fMRI can guide customized coil placement, potentially leading to better outcomes.
Early results are encouraging, suggesting that TMS may improve memory and thinking skills; however, the studies are ongoing, and more data are needed to confirm its effectiveness.
Other research reviews show similar promise, with TMS targeting the prefrontal and parietal lobes helping some patients with MCI. However, scientists are still determining the optimal settings, such as how frequently to use TMS and what intensity and frequency the pulses should be. While not yet a standard treatment, these findings hold promise for a new approach to managing MCI.
For most people, TMS is safe when done by trained professionals. Common side effects are mild, such as scalp discomfort or a slight headache, which typically subside quickly. Serious risks, like seizures, are extremely rare. If you’re considering TMS, your doctor will review your health history to ensure it’s safe for you, especially if you have conditions like epilepsy or metal implants in your head.
If you or a loved one has MCI, TMS could be worth exploring, especially if you prefer non-drug options or haven’t found relief with medications. However, it’s not a proven treatment, and research is still developing. Another drawback is that the treatment is time-consuming and expensive.
One of my colleagues, Dr. Gayatri Devi, has been using transcranial magnetic stimulation (TMS) to improve memory in her patients for over a decade. She gets the credit for convincing me to start using TMS at the New York Headache Center for refractory chronic migraine headaches, other pain conditions, as well as a variety of different neurological conditions, such as poor memory, long-COVID, post-concussion syndrome, brain fog, dizziness, and others. We are fortunate to have access to a research facility that conducts fMRI scans. This allows for an individualized approach to treating all these conditions in our patients.
