Personalized Intermittent Theta Burst Stimulation for Cognitive Impairment Related to Cerebral Small Vessel Disease

Inclusion Criteria: 1. Aged 45-85 years, of either sex. 2. Cognitive decline in memory or another cognitive domain, reported by the participant or an informant, lasting at least three months; brain MRI evidence of cerebral small vessel disease (CSVD); and a diagnosis of CSVD-related vascular cognitive impairment. 3. Vascular mild cognitive impairment or mild vascular dementia. Vascular mild cognitive impairment is defined as impairment in one or more cognitive domains with largely preserved independence in daily activities. Mild vascular dementia is defined as cognitive impairment that mildly affects instrumental activities of daily living or activities of daily living, while the participant remains able to complete study assessments and treatment. 4. Neuropsychological evidence of cognitive impairment: Mini-Mental State Examination (MMSE) score ≥18 and \<28, with a lower threshold of ≥16 for participants with primary school education; Clinical Dementia Rating (CDR) score of 0.5 or 1; or cognitive impairment determined after adjustment for educational attainment. 5. Relatively stable overall functional status, with a modified Rankin Scale (mRS) score ≤2. 6. Brain MRI findings consistent with CSVD, meeting at least one of the following: 7. Multiple supratentorial small subcortical infarcts, with or without white matter lesions. 8. Moderate-to-severe white matter hyperintensities, with a Fazekas score ≥2, with or without lacunar infarcts. 9. Other CSVD-related imaging findings, such as cerebral microbleeds or enlarged perivascular spaces. 10. No acute cerebrovascular event, including acute cerebral infarction, intracerebral hemorrhage, or transient ischemic attack, within the preceding three months. 11. No or only mild hippocampal/medial temporal lobe atrophy, with a medial temporal atrophy (MTA) score of 0-1. 12. Written informed consent voluntarily provided by the participant or their legally authorized representative. Exclusion Criteria: 1. Cognitive impairment primarily explained by another disease, including Alzheimer's disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson's disease-related cognitive impairment, normal pressure hydrocephalus, brain tumor, demyelinating disease, encephalitis, epilepsy, or severe traumatic brain injury. 2. Large cortical infarction, watershed infarction, strategic infarction, intracerebral hemorrhage, hydrocephalus, or another brain lesion sufficient to explain the cognitive impairment. 3. Impaired consciousness from any cause. 4. Severe depression, a psychotic disorder, or another severe psychiatric disorder. 5. Severe systemic disease or a metabolic abnormality that may cause cognitive impairment, such as severe hepatic or renal dysfunction, thyroid dysfunction, vitamin B12 or folate deficiency, severe anemia, or active infection. 6. A history of alcohol or drug abuse or dependence. 7. A contraindication to intermittent theta burst stimulation (iTBS), including a history of seizures, a first-degree relative with epilepsy, intracranial metal implants, a cardiac pacemaker, a cochlear implant, a deep brain stimulator, a vagus nerve stimulator, or another implanted electronic or metallic medical device. 8. A contraindication to MRI or inability to complete MRI examinations, such as metal implants or claustrophobia. 9. Transcranial magnetic stimulation or another neuromodulation treatment within the preceding three months. 10. Pregnancy, breastfeeding, or plans to become pregnant during the study. 11. Current participation in another interventional clinical study. 12. Any other condition that, in the investigator's judgment, makes the individual unsuitable for participation.