Quantitative and Repetitive TMS in ALS - Recruiting for Stage 2

Inclusion Criteria: * Diagnosis with ALS as per the 2020 Gold Coast Criteria; * Age ≥ 18 years; * Able to provide informed consent to study procedures and treatments; * Patients are allowed to start or continue the standard of care treatments for ALS. Presently these include oral riluzole, and oral or intravenous edaravone; * Able to lie supine without BiPAP or breathing discomfort for at least 1 hour; * No contraindications to TMS as follow; * Metal implants in the head or neck (such as aneurysm clips, vessel stents), implanted medication pump, implanted brain stimulators, pacemaker, cochlear implants, or history of epilepsy. Dental fillings are permitted; * Current use of medications or medical conditions that, at the discretion of the Principal Investigator, could potentially increase the risk of seizures or interfere with stage outcomes; * On medications that affect TMS measures in a PRN regimen (as needed). Continuous use of these medications on a fixed dose of 30 days prior to first Baseline Visit or after a wash-out period of 2 weeks is accepted. These medications include, but are not limited to: benzodiazepines, muscle relaxants, tricyclic antidepressants, selective and non-selective serotonin reuptake inhibitors, hypnotics (including anti-histamine drugs) and anticholinergics drugs; * History of seizure, convulsion, or epilepsy; Exclusion Criteria: * Known diagnosis of dementia; * Definitely or possibly pregnant (if applicable); * History of allergy to Ag-AgCl ele…