Beyond the Fog: How dTMS is Rewriting the Story of Alzheimer’s Treatment

Shifting the paradigm from managing loss to actively empowering the brain

By Jess Wight | 09 October, 2026

“The goal is to restore connections between neurons by enhancing activity in certain areas relevant to the disease. This therapy is like training for the neurons.”

Dr Giacomo Koch, professor of Human Physiology and co-founder of Sinaptica, discussing the theory behind their TMS research

For decades, the search for effective Alzheimer’s treatments has felt like navigating a dense, unpredictable landscape. While traditional approaches have largely focused on the chemical and biological pathways involved in neurodegeneration, scientists are now exploring whether non-invasive magnetic stimulation can work directly with the brain’s electrical networks and offer a new path forward for cognitive health.

At the forefront of this shift is deep Transcranial Magnetic Stimulation (dTMS), an advanced form of non-invasive neuromodulation that uses magnetic fields to spark activity across targeted brain networks. Rather than introducing medication into the bloodstream or requiring an invasive procedure, dTMS works from outside the skull, delivering carefully controlled magnetic pulses that induce electrical activity within the brain. This unique ability to directly modulate neural circuits has made dTMS an increasingly vital area of research – transforming care in conditions ranging from major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) to neurological disorders and, more recently, Alzheimer’s disease.

The path to dTMS grew out of from standard Repetitive Transcranial Magnetic Stimulation (rTMS). Early clinical trials into rTMS and Alzheimer’s demonstrated that repeated magnetic stimulation could boost cortical excitability and neuroplasticity – the brains natural ability to adapt and form new connections - with studies reporting real improvements in key areas of cognitive performance. A 2019 systematic review and meta-analysis reinforced this promise, finding clear evidence that rTMS could improve cognitive outcomes for people living with Alzheimer’s, leading researchers to highlight rTMS as a safe, feasible and hopeful option.

Traditional rTMS, however, comes with a fundamental physical limitation. Its conventional figure-8 coil creates a concentrated, focal magnetic field designed for shallow cortical tissue. While that precision works well when targeting a single surface spot, Alzheimer’s disease is not confined to one small area on the surface of the brain. It affects complex, interconnected networks involved in memory, attention, language and executive function, with changes extending into deeper brain regions.

This realization inspired researchers to explore whether a broader form of stimulation could engage more of these interconnected circuits simultaneously. BrainsWay’s H-Coil technology was built around this principle. Instead of pinpointing a small, isolated area, the H-Coil generates a broader electromagnetic field capable of comfortably reaching deeper, distributed neural structures. BrainsWay describes its dTMS system as reaching wider and deeper brain regions than first-generation TMS devices, utilizing specialized H-Coils designed for different neural targets and clinical indications.

This technological evolution led directly to BrainsWay’s proprietary H-Coil technology, specifically designed to overcome the depth limitations and rapid signal decay of figure-8 coils. In conditions like Major Depressive Disorder (MDD), where deeper frontostriatal pathways are involved, dTMS has demonstrated clear life-changing advantages over standard rTMS:

-          Deeper and Broader Penetration: dTMS reaches targeted brain regions up to 0.75 inches (1.9cm) beneath the skull – roughly double the depth of standard rTMS – stimulating wider neural networks simultaneously.

-          Higher Efficacy in Treatment-Resistant MDD: Real-world studies show response rates reaching up to 75% for patients with MDD who have struggled to find relief from prior antidepressants or standard rTMS.

-          Broader FDA Clearances: Beyond MDD, dTMS’s ability to engage deeper subcortical networks has earned FDA clearances for difficult-to-treat conditions like obsessive-compulsive disorder (OCD) and smoking addiction.

-          Reduced Targeting Error: The broader field gradient minimizes the risk of missing the optimal target areas, making treatments consistently effective across varying brain anatomies.

This technology already carries an established, proven history in clinical care. In a large real-world analysis of more than 1,300 patients treated with the H1 coil for depression, the reported response rate reached an incredible 81.6%, with a 65.3% remission rate. This is just one of many studies performed in a community setting, demonstrating the substantial clinical foundation built around this powerful technology.

The significance of these findings for Alzheimer’s research isn’t just about translating depression data directly to cognitive health. Rather, it provides a proven technological foundation that gives researchers confidence to explore whether the exact same principles of network modulation can revitalize cognitive function.

Importantly, dTMS and Alzheimer’s are far more than a theoretical match – dTMS has already been studied directly in people living with Alzheimer’s.

One of the earliest studies, published in 2016, treated patients living with moderate-to-severe Alzheimer’s disease with 20 sessions of dTMS targeting the prefrontal cortex. Cognitive performance was evaluated using both the Addenbrooke’s Cognitive Examination (ACE) and the computerized MindStreams testing. The results offered an exciting early signal: following treatment, 77% of participants improved on the ACE assessment, while 60% showed performance boosts on MindStreams. Remarkably, the subgroup of more advanced disease experienced a statistically significant improvement on the ACE. This landmark study demonstrated that deep stimulation could be delivered to people with Alzheimer’s disease and that measurable, encouraging changes in cognitive performance could occur following treatment.

The next step was putting those observations to a more rigorous test. Researchers conducted a double-blind, sham-controlled pilot study in 2021 specifically examining H-Coil stimulation in Alzheimer’s disease. Using the H2-coil to stimulate bilateral frontal, parietal and temporal regions, researchers shifted toward influencing a wider network of brain areas involved in cognitive processing during an 8-week course of dTMS.

The results were both encouraging and deeply instructive. Participants receiving active H-Coil stimulation showed significant cognitive improvements on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) compared to the control group. While benefits tapered two months after the trial ended, the study confirmed that H1-Coil stimulation is feasible, well-tolerated, and capable of generating real cognitive gains.

This study introduced a crucial concept for the future of Alzheimer’s care: maintenance matters. Because Alzheimer’s is a progressive condition, maintaining brain activity over time is key. The finding that cognitive gains faded after sessions ended doesn’t diminish the success; instead, it gives researchers a clear roadmap for designing ongoing treatment protocols that sustain those improvements long-term.

Alzheimer’s fundamentally disrupts how different regions of the brain communicate, which is why researchers are shifting away from looking at isolated structures and focusing on full network connectivity.  

Memory is not stored in one location – it lives in the active communication between multiple brain regions involved in learning, recall, and emotion. As Alzheimer’s develops, those communication pathways can become disrupted, leading to “cortical slowing”. This provides a compelling rationale for dTMS: rather than trying to “turn on” a single isolated memory center, dTMS can harmonize entire interconnected networks simultaneously.

One network attracting particular attention is the Default Mode Network, which plays an important role in memory and other higher-order cognitive functions. Disruptions in this network are among the hallmark features researchers have associated with Alzheimer’s disease.

Recent research demonstrates that dTMS can directly influence these large-scale networks. A 2026 proof-to-concept study examining dTMS stimulation of the posterior cingulate region found positive changes in functional connectivity across interconnected areas of the Default Mode Network. While conducted with healthy adult participants to examine biological mechanisms, it provided clear proof that dTMS influences communication across wide neural networks, far beyond the surface tissue immediately beneath the coil.

This network-based approach is also being illuminated through quantitative electroencephalography (QEEG), which measures patterns of electrical activity in the brain. In Alzheimer’s, QEEG reveals increased slow-wave activity and changes in how faster, active brain frequencies synchronize – giving researchers a clear lens to watch the brain respond to treatment.

A particularly interesting recent study examined the effects of dTMS in people living with early-stage Alzheimer’s disease and co-occurring MDD. Participants received 36 sessions using BrainsWay’s H1 and H7 coils targeting frontal and temporal regions, with QEEG tracking changes before and after treatment.

The results showed measurable, positive shifts in electrophysiological activity. First, the study indicated a restoration of brain communication, as researchers reported an increase in alpha coherence – a key biological marker signaling that the frontal and temporal brain regions were synchronizing and communicating better. Researchers also observed a reversal of cortical slowing, with reduced delta frequency power in the temporal lobe. Alongside these biological changes came incredible clinical improvements: over 83% of participants experienced significant relief from depressive symptoms, with 50% achieving full remission on the PHQ-9. 

These findings offer a fascinating glimpse into what may be happening beneath the surface. The study didn’t just ask if patients felt better – it visually proved that the brain’s electrical activity was actively changing and re-energizing.

This provides an encouraging indication that dTMS can produce measurable, positive neurophysiological changes in people with early-stage Alzheimer’s while lifting mood at the same time.

Depression and cognitive decline frequently coexist, creating an additional emotional load for patients, families and caregivers. Depression can affect concentration, motivation, sleep and memory, making existing cognitive difficulties feel even heavier. This is an area where the established clinical experience with dTMS for depression becomes particularly relevant. dTMS is already FDA-cleared for depression, with large real-world studies demonstrating substantial relief in everyday clinical practice.

For someone experiencing both depression and early-stage Alzheimer’s, the opportunity to support mood and energize brain activity using the same gentle, non-invasive technology is deeply promising. The recent QEEG pilot demonstrates that measurable, positive changes in brain physiology accompany real clinical improvements in everyday life.  

The broader rTMS literature adds even more encouraging context. Numerous studies investigating magnetic stimulation for Alzheimer’s report improvements in cognitive measures, with a 2019 systematic review and meta-analysis concluding that rTMS holds immense potential as an intervention for cognitive impairment in Alzheimer’s disease.

Because Alzheimer’s varies from person to person, there isn’t a one-size-fits-all protocol. That’s why the next stage of research is moving toward personalized neuromodulation – tailoring how deeply and broadly networks are stimulated, how frequently treatments are delivered, and how maintenance sessions can best preserve cognitive clarity.

Current clinical trials are actively bringing this personalized vision to life. A UCLA trial is investigating large-coil, or deep, rTMS directed toward the precuneus and surrounding parietal regions in people with mild cognitive impairment and mild-to-moderate Alzheimer’s disease. The study combines cognitive assessments with brain imaging, electrophysiological measurements and blood-based biomarkers, allowing researchers to examine both clinical outcomes and biological changes.

For anyone affected by Alzheimer’s disease, it is helpful to distinguish between a promising area of active research and an established clinical indication. While dTMS is not yet FDA-cleared specifically for Alzheimer’s, early studies are building an undeniable scientific foundation. Specialized H-Coil stimulation has demonstrated cognitive gains in randomized pilot studies, while newer research continues to show how magnetic fields can directly re-energize electrical activity and network connectivity.

For patients and families, this opens a hopeful new conversation around Alzheimer’s care. Rather than viewing the brain solely in terms of what has been damaged, researchers are focusing on what can still be empowered, supported, and reactivated within the living brain. That is where the ultimate promise of dTMS lies.

“As you look at large populations, you immediately realize that what we call Alzheimer’s disease is not one disease, it’s multiple diseases that each have very different outcomes. To have a one-size-fits-all approach to this complex disease does not serve us well.”

Elias Zerhouni, former director of the National Institutes of Health, discussing the trajectory of Alzheimer’s research

The future of Alzheimer’s care will likely combine multiple supportive tools – from lifestyle and cardiovascular health to psychological care and targeted brain stimulation. Neuromodulation offers an exciting, drug-free component to this holistic vision, directly supporting brain function alongside other therapies.

The most inspiring possibility is that dTMS will become increasingly personalized. Advanced brain imaging and electrophysiological testing could soon help map each individual’s unique neural networks, allowing clinicians to tailor stimulation protocols to exact needs and track long-term response.

From early 2016 studies to current sham-controlled trials and connectivity research, scientists are painting a clear, optimistic picture of what non-invasive brain stimulation can achieve. For a condition traditionally associated with loss, actively engaging the brains remaining networks represents a profound shift in perspective. dTMS offers a scientifically grounded, deeply hopeful opportunity to stimulate, support, and optimize the brain’s surviving networks – helping preserve clarity and connection for the future.