Assessing the Impact of dTMS on Neural Targets Associated With Alcohol Use Disorder

Inclusion Criteria:

* Age 18-75.
* Current DSM-5 diagnosis of moderate to severe AUD (\≥4 diagnostic symptoms).
* Ability to obtain a Motor Threshold (MT) will be determined during the screening process.
* Has an adequately stable condition and environment to enable attendance at scheduled clinic visits.
* Able to read, understand and voluntarily sign the Informed Consent Form prior to participating in any study-specific procedures or assessments.
* If on a medication regimen for comorbid symptoms, that regimen will be stable for the duration of the study and patient will be willing to remain on this regimen during the treatment phase.
* Fluency in English.

Exclusion Criteria:

* Transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI) contraindications: such as a cardiac pacemaker, cochlear implant, or an implanted device (deep brain stimulation, metal in the head, metal in the body, claustrophobia, pregnant or breastfeeding or other ferromagnetic device/objected in the head and body within 30 cm of the treatment coil.
* General medical condition, disease or neurological disorder that interferes with the assessments or participation.
* Unable to safely withdraw, at least two weeks prior to treatment, from medications that increase seizure risk.
* Current substance abuse (except caffeine or nicotine) as determined by positive toxicology screen.
* Have a mass lesion, cerebral infarct, or other active CNS disease, including an alcohol-related seizure or a seizure disorder.
* A recent suicide attempt (defined as within the last 30 days) or presence of current suicidal plan or intent. Patients at risk for suicide will be required to establish a written safety plan involving their primary therapist before entering the study.
* Severe impediment to vision, hearing and/or hand movement, likely to interfere with the ability to follow study protocols.
* Greater than mild traumatic brain injury (defined as greater than 10 minutes loss of consciousness).
* Taking benzodiazepine or neuroleptic medications, or any medication known to alter seizure threshold
* Acute or unstable chronic illness.
* Current or lifetime history of bipolar disorder or psychosis