rTMS to Improve Cognition in Parkinson's

Inclusion Criteria:

• Veterans who seek services at Hines VA Hospital or Jesse Brown VA Medical Center

• Diagnosis of PD or atypical parkinsonism as determined by a neurologist

• Meet criteria for having mild cognitive impairment

• Receiving stable (i.e., no changes in medication and medication dose) medication andwho are expected to remain on stable medication for the duration of the RCT

• Speak and read English

• 50 years or older

Exclusion Criteria:

• Dementia

• Failure to demonstrate decision making capacity

• History of deep brain stimulation surgery

• Severe depression

• Resting head tremor

• Dyskinesia that will interfere with collecting imaging data

• Has congestive heart failure

• Implanted cardiac pacemaker or defibrillator

• Cochlear implant, nerve stimulator, or intracranial metal clips

• Implanted medical pump

• Increased intracranial pressure

• History of claustrophobia

• Metal in eyes/face, shrapnel/bullet remnants in brain

• Participants at potential increased risk of seizure including those who have thefollowing:

• history (or family history) of seizure or epilepsy

• history of stroke, head injury, or unexplained seizures

• presence of other neurological disease that may be associated with an alteredseizure threshold

• such as CVA, cerebral aneurysm, dementia, increased intracranial pressure

• Concurrent medication use such as tricyclic antidepressants, neurolepticmedications, any other drug known to lower seizure threshold

• Secondary conditions that may significantly alter electrolyte balance or lowerseizure threshold

• No quantifiable motor threshold such that rTMS dosage cannot be accuratelydeter-mined