In 1906, Dr. Alois Alzheimer stood before a room of psychiatrists in Tübingen, Germany, and described a case that would change history. His patient, Auguste Deter, had been slowly slipping away—losing memories, forgetting faces, and struggling to make sense of the world. When she died, Alzheimer examined her brain and found it riddled with plaques—sticky protein clumps jamming neural connections—and tangles—twisted fibres strangling brain cells. He had uncovered the biological signature of what would become one of the most feared diseases of the modern era.
More than a century later, despite billions of dollars poured into research, Alzheimer’s disease remains incurable. Over 55 million people worldwide live with it today, a number expected to triple by 2050. The newest drugs can slow the disease, but they cannot stop it. This raises a pressing question: if medication alone isn’t enough, is there another way to fight back?
For decades, doctors have treated Alzheimer’s like a chemical problem, trying to correct the imbalance in the brain’s messaging system. The most common medications work by boosting a compound called acetylcholine, which helps brain cells communicate. In a healthy brain, this chemical flows freely, helping neurons pass messages from one to another. But in Alzheimer’s, those connections break down, and the drugs can only do so much to compensate. They don’t stop the damage; they simply make the symptoms a little less severe for a little longer.
More recently, scientists have focused on beta-amyloid, a protein that builds up into plaques—the same kind that Alzheimer saw under his microscope. New treatments, like the recently approved drug lecanemab, are designed to clear some of these plaques. And they do—just not fast enough. At best, they slow the disease by a few months. At worst, they can cause brain swelling or bleeding, forcing some patients to stop treatment altogether.
So far, every approach has one major flaw: it tries to fix the chemistry of the brain without addressing its electricity.
Imagine a car that won’t start. No matter how much fuel you add, the engine won’t turn over unless the spark plugs fire. The human brain works in much the same way. It is more than just a soup of chemicals—it’s an intricate circuit, firing tiny electrical pulses to carry thoughts, memories, and emotions. It needs chemical fuel, but it also needs electrical signals to keep things running. And in Alzheimer’s, those signals begin to fail.
When those signals fail, medication alone may not bring them back. This is why some scientists are turning to a completely different approach: not chemistry, butelectricity itself.
Enter Transcranial Magnetic Stimulation (TMS). By sending magnetic pulses into the brain, scientists try to “jumpstart” or stimulate those failing signals. It doesn’t require surgery or implants—just a device that rests against the scalp, creating a gentle magnetic field that reaches the neurons beneath. These pulses nudge brain cells back into action, almost like waking them up from a deep sleep.
Originally developed to treat depression, TMS has shown surprising potential in Alzheimer’s patients. A recent study found that people who received regular TMS sessions showed improvements in memory and attention, even months after treatment. Brain scans revealed something remarkable: areas of the brain that had gone quiet—regions responsible for storing and retrieving memories—started lighting up again.
No drug has ever done that.
One of the most studied areas for TMS is the dorsolateral prefrontal cortex (DLPFC), a region essential for working memory and planning. In 2020, a study found that patients with mild to moderate Alzheimer’s showed improvements in memory and cognitive function after high-frequency repetitive TMS (rTMS). More recent studies suggest these effects can even help patients stay more independent in daily life.
Interestingly, combining TMS with cognitive training yielded better results than TMS alone. A study in 2023 found that pairing brain stimulation with memory exercises amplified the benefits. This combination likely strengthens neural pathways that are being “reawakened” by the magnetic pulses. In another 2023 study, patients who underwent this dual therapy experienced more sustained improvements, especially when targeting the DLPFC.
Of course, TMS isn’t a miracle cure. It won’t reverse Alzheimer’s or stop it in its tracks. Scientists are still working to determine the best way to use it—how often, at what intensity, and which parts of the brain to target.
Moreover, not all patients respond to TMS. One reason could be the stage of Alzheimer’s at the time of treatment. TMS appears most effective in early or moderate stages, before too many neural connections are lost. Genetic factors, such as variations in the APOE4 gene (a known risk factor for Alzheimer’s), may also play a role. Some researchers speculate that individuals with certain genetic profiles may have more responsive or resilient neural circuits.
Another factor is neuroplasticity—the brain’s ability to reorganise itself. Some patients may have more adaptable neural networks, making it easier for TMS to strengthen or rewire connections. Individual factors such as age, gender, and education level also play a role in treatment outcomes. For instance, younger patients and those with higher education levels may exhibit more pronounced cognitive gains.
And then there’s the issue of accessibility. Unlike pills that can be prescribed and picked up at a pharmacy, TMS requires specialised equipment and trained professionals, which makes it difficult to offer on a large scale. While TMS is generally well-tolerated, it’s not without its risks. The most common side effects include mild headaches, scalp discomfort, or tingling during treatment. For most patients, these symptoms subside quickly. However, rare but more serious complications can occur, including seizures. This risk is higher for individuals with epilepsy or other neurological conditions, so careful screening is essential before starting treatment.
Another challenge is sustainability. The effects of TMS often wear off over time unless sessions are repeated periodically. This raises questions about how to make ongoing treatment more accessible and cost-effective. Additionally, more research is needed to fine-tune the ideal frequency, duration, and targeting for different stages of Alzheimer’s.
Still, the idea is gaining momentum. Researchers are now exploring whether artificial intelligence could map each patient’s brain activity and tailor TMS treatments to their unique neural patterns.
For now, TMS offers something that has been rare in Alzheimer’s treatment: hope. If magnetic pulses can help patients hold onto their memories a little longer, recognise their loved ones for a few more months, or maintain independence for another year, then maybe, just maybe, we’re closer to a breakthrough than we think.
Cover image- iStock
