Optimizing Connectivity-Guided Theta Burst Stimulation Targeting for Memory Enhancement in Mild Cognitive Impairment

Motivation: Theta burst stimulation shows promise for memory enhancement in mild cognitive impairment and Alzheimer's disease. Optimizing stimulation target and protocols is essential for effective intervention. Goal(s): To evaluate three MRI-guided TBS targeting strategies —structural connectivity, functional connectivity, and combined SC+FC —to identify parietal subregions supporting memory enhancement. Approach: Retrospective analysis of 40 MCI participants, assessing correlations between connectivity-informed targets and memory outcomes to determine optimal target alignment. Results: cTBS enhanced memory in posterior inferior parietal cortex subregions (PGs, PGi, PGp) and intraparietal sulcus (IP0). iTBS was most effective in superior parietal subregions (7AL, 7Am, 7PL) and intraparietal sulcus (VIP), highlighting the value of connectivity-guided targeting. Impact: This study demonstrates that connectivity-informed TBS targeting enhances memory, revealing distinct interaction effects across TBS protocols and parietal subregions. The findings support personalized, connectivity-based brain stimulation as a potential therapeutic approach for memory deficits in neurodegenerative conditions.