TMS for Cognitive Decline in Aging and Preclinical AD

Inclusion criteria

• Between the ages of 40-99
• Native English speakers
• Willing and able to consent to the protocol and undergo imaging and neuropsychological testing at the specified time points
• Cognitively normal older adults and individuals with preclinical Alzheimer's disease will be included.

Exclusion criteria

• History of head trauma involving loss of consciousness or alteration in consciousness
• Another major neurologic or psychiatric condition
• Known presence of a structural brain lesion (e.g. tumor, cortical infarct)
• Any contraindication to MRI, such as presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments, or foreign objects in the eyes, skin, or body
• Longstanding premorbid history (i.e. longer than 10 years) of alcohol or substance abuse with continuous abuse up to and including the time that the symptoms leading to clinical presentation developed
• Any significant systemic illness or unstable medical condition which could lead to difficulty complying with the study protocol.
• Unwilling to return for follow-up, undergo neuropsychological testing, TMS, and MR imaging
• History of unprovoked seizures (i.e., seizures that occur in the absence of a clear provocation such as hyponatremia, hypoglycemia, etc.).
• Subjects who have a first degree relative (e.g., father, mother or sibling) with a seizure disorder.
• Subjects currently taking, or plan to take, medications which are highly epileptogenic. These include: clozapine, high doses of bupropion (i.e., greater than 400mg daily), diphenhydramine, cyclosporine, isoniazid, imipenem, chloroquine, tramadol and theophylline.