Spectral EEG-Guided Adaptive Neuromodulation for Age-Related Cognitive Changes: A Longitudinal Case Report

Targeted interventions for age-related cognitive changes in older adults are complicated by co-occurring factors such as depression, anxiety, executive dysfunction, and treatment heterogeneity, necessitating strategies that integrate cognitive, affective, and functional symptom management. This case report explores functional, affective, sleep, and quality of life outcomes following EEG-spectra-guided personalized repetitive transcranial magnetic stimulation (PrTMS, PeakLogic, Inc., San Diego, CA) for a patient experiencing age-related cognitive changes. Weekly assessments showed improvements in perceived cognitive function, sleep, mood, and quality of life, quantified via Perceived Deficits Questionnaire - Depression (PDQ-D5), Sleep Condition Indicator (SCI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item Scale (GAD-7), and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF). Our findings show promise that EEGspectra-guided PrTMS is potentially beneficial for addressing age-related cognitive and functional changes. Furthermore, our findings show longitudinal symptom improvements consistent with engagement of adaptive neuroplasticity. Further largescale, randomized and blinded studies are recommended to validate our observations on the feasibility of PrTMS for age-related cognitive changes.