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 and who 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 the following:

  * 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 altered seizure threshold

    * such as CVA, cerebral aneurysm, dementia, increased intracranial pressure
* Concurrent medication use such as tricyclic antidepressants, neuroleptic medications, any other drug known to lower seizure threshold
* Secondary conditions that may significantly alter electrolyte balance or lower seizure threshold
* No quantifiable motor threshold such that rTMS dosage cannot be accurately deter-mined