iTBS rTMS in Mild Cognitive Impairment

Inclusion Criteria * Must speak English fluently * Diagnosis of MCI as defined by: * Clinical diagnosis by a neurologist * Neuropsychological testing support of MCI * Meet criteria for MCI * Subjective cognitive decline reported by participant and/or an informant * Objective memory impairment in one or more cognitive domains for age * Essentially preserved general cognitive function * Largely intact functional activities * Does not meet criteria for dementia as judged by a clinician * Eligible for transcranial magnetic stimulation (TMS) based on safety criteria * Clinical Dementia Rating=0.5 * Geriatric Depression Scale score less than 6 * Medically stable and in good general health * Not pregnant, lactating, or of childbearing potential * Stable medication regimen for at least 4 weeks prior to baseline visit * Adequate visual and auditory abilities to complete neuropsychological testing * Ability to provide informed consent * Have a care partner who is available to accompany the participant to study visits for the duration of the protocol. Exclusion Criteria * Inability to communicate in the English language * Meet criteria for dementia * Contraindications to TMS or MRI, including patients who have * conductive, ferromagnetic or other magnetic-sensitive metals implanted in their head or within 30 cm of the treatment coil (e.g., cochlear implants, implanted electrodes/stimulators, aneurysm clips or coils, stents, bullet fragments or jewelry) * active or inactive implants, including deep brain stimulators, cochlear implants, vagus nerve stimulators or implanted device leads * Any true positive findings on the TMS safety screening form * Prior exposure to TMS, electroconvulsive therapy (ECT), or any neurostimulation within the past 12 months * History of epilepsy or seizures * Medical conditions that increase risk of seizures * History of traumatic brain injury * History of intracranial mass or lesion * History of stroke, including hemorrhagic stroke and ischemic stroke * Psychiatric disorders * Primary psychotic disorder (schizophrenia, schizoaffective, or schizophreniform disorder), any history * Primary mood disorder (major depressive disorder, bipolar disorder) within the past 12 months * Substance use disorder (except caffeine and nicotine) within the past 12 months * Active symptoms of depression, anxiety, mania, psychosis, or substance use (except caffeine and nicotine) within the past year * Active symptoms of depression will be identified based on geriatric depression scale ≥ 6 * Other active symptoms of psychiatric conditions to be determined by study investigators * Sleep disorders that are considered clinically significant and not sufficiently treated by the investigative team, including untreated obstructive sleep apnea (apnea-hypopnea index \>15), untreated/suboptimally treated REM sleep behavior disorder, untreated/suboptimally treated restless legs syndrome * Pregnancy or suspected pregnancy * Participation in another concurrent interventional clinical trial * Any unstable medical condition * Inability to provide informed consent * Inability to adhere to the protocol