Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial
Abstract Introduction Persistent postural-perceptual dizziness (PPPD) is a chronic functional dizziness often triggered by vestibular, psychological, or environmental factors. Current treatments, including pharmacological and cognitive therapies, show limitations. In recent years, transcranial magne...
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Adis, Springer Healthcare
2025-03-01
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| Series: | Neurology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40120-025-00733-x |
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| author | Wenze Li Chang Liu Yuqing Zhang Maolin Peng Xiuhang Luo Hongfa Zhang Hairong Lan Zhipeng Li Yankun Chen Zhen Li Zhimin Xiao Linyan Tong Yangmei Chen |
| author_facet | Wenze Li Chang Liu Yuqing Zhang Maolin Peng Xiuhang Luo Hongfa Zhang Hairong Lan Zhipeng Li Yankun Chen Zhen Li Zhimin Xiao Linyan Tong Yangmei Chen |
| author_sort | Wenze Li |
| collection | DOAJ |
| description | Abstract Introduction Persistent postural-perceptual dizziness (PPPD) is a chronic functional dizziness often triggered by vestibular, psychological, or environmental factors. Current treatments, including pharmacological and cognitive therapies, show limitations. In recent years, transcranial magnetic stimulation (TMS) has been explored in other neuropsychiatric disorders but has not been studied extensively for PPPD. Objective We aimed to evaluate the efficacy and safety of TMS of the left high-frequency dorsolateral prefrontal cortex (DLPFC) in improving dizziness and mood disorders in patients with PPPD in a single-blind, placebo-randomized controlled trial. Methods This trial recruited patients from October 8, 2023, to June 30, 2024, with follow-up completed on September 30, 2024, of 80 patients screened from the second affiliated hospital of Chongqing Medical University in China. Totals of 4 patients were excluded and 66 patients were randomized. PPPD patients were randomized to receive either TMS (10 Hz, 20 min) or SHAM-TMS treatments to the left DLPFC over ten sessions within 2 weeks. Dizziness severity, anxiety, and depression quality were assessed at baseline, post-treatment, and 1 and 3 months. Adverse events were also monitored. Results Of 66 eligible patients [median (IQR) age, 54.5 (49.8–67.0) years; Of 42 women (63.6%)], 33 were randomized to the TMS group, and 33 were randomized to the SHAM-TMS group. After three months, a total of 52 participants (TMS group [n = 27]; SHAM-TMS group [n = 25)] completed the follow-up. At 2 weeks, 1 month, and 3 months post-treatment, the TMS group exhibited significant reductions in the levels of dizziness and anxiety compared to both their baseline measurements and the SHAM-TMS group at the same time points (all, p < 0.05). In the SHAM-TMS group, dizziness showed a significant improvement only at 2 weeks post-treatment compared to baseline (p < 0.05). Additionally, in the TMS group, Hamilton Depression Rating Scale (HAMD) scores decreased at both 2 weeks and 1 month relative to baseline. In contrast, the SHAM-TMS group displayed no significant changes in HAMD scores during the 3-month follow-up. Conclusion TMS targeting the DLPFC significantly alleviated symptoms of dizziness and anxiety in patients with PPPD. This non-invasive treatment may offer a safe and effective therapeutic alternative for managing PPPD symptoms. Further large-scale studies are recommended to confirm these findings. Trial Registration ClinicalTrials.gov identifier, CTR2400093690. |
| format | Article |
| id | doaj-art-4ba112a575a347789dc019e44602aa19 |
| institution | OA Journals |
| issn | 2193-8253 2193-6536 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Adis, Springer Healthcare |
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| series | Neurology and Therapy |
| spelling | doaj-art-4ba112a575a347789dc019e44602aa192025-08-20T01:53:15ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362025-03-0114384986310.1007/s40120-025-00733-xEfficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled TrialWenze Li0Chang Liu1Yuqing Zhang2Maolin Peng3Xiuhang Luo4Hongfa Zhang5Hairong Lan6Zhipeng Li7Yankun Chen8Zhen Li9Zhimin Xiao10Linyan Tong11Yangmei Chen12Department of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Geriatrics, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityRehabilitation Medical Center, Southwest University HospitalDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical UniversityAbstract Introduction Persistent postural-perceptual dizziness (PPPD) is a chronic functional dizziness often triggered by vestibular, psychological, or environmental factors. Current treatments, including pharmacological and cognitive therapies, show limitations. In recent years, transcranial magnetic stimulation (TMS) has been explored in other neuropsychiatric disorders but has not been studied extensively for PPPD. Objective We aimed to evaluate the efficacy and safety of TMS of the left high-frequency dorsolateral prefrontal cortex (DLPFC) in improving dizziness and mood disorders in patients with PPPD in a single-blind, placebo-randomized controlled trial. Methods This trial recruited patients from October 8, 2023, to June 30, 2024, with follow-up completed on September 30, 2024, of 80 patients screened from the second affiliated hospital of Chongqing Medical University in China. Totals of 4 patients were excluded and 66 patients were randomized. PPPD patients were randomized to receive either TMS (10 Hz, 20 min) or SHAM-TMS treatments to the left DLPFC over ten sessions within 2 weeks. Dizziness severity, anxiety, and depression quality were assessed at baseline, post-treatment, and 1 and 3 months. Adverse events were also monitored. Results Of 66 eligible patients [median (IQR) age, 54.5 (49.8–67.0) years; Of 42 women (63.6%)], 33 were randomized to the TMS group, and 33 were randomized to the SHAM-TMS group. After three months, a total of 52 participants (TMS group [n = 27]; SHAM-TMS group [n = 25)] completed the follow-up. At 2 weeks, 1 month, and 3 months post-treatment, the TMS group exhibited significant reductions in the levels of dizziness and anxiety compared to both their baseline measurements and the SHAM-TMS group at the same time points (all, p < 0.05). In the SHAM-TMS group, dizziness showed a significant improvement only at 2 weeks post-treatment compared to baseline (p < 0.05). Additionally, in the TMS group, Hamilton Depression Rating Scale (HAMD) scores decreased at both 2 weeks and 1 month relative to baseline. In contrast, the SHAM-TMS group displayed no significant changes in HAMD scores during the 3-month follow-up. Conclusion TMS targeting the DLPFC significantly alleviated symptoms of dizziness and anxiety in patients with PPPD. This non-invasive treatment may offer a safe and effective therapeutic alternative for managing PPPD symptoms. Further large-scale studies are recommended to confirm these findings. Trial Registration ClinicalTrials.gov identifier, CTR2400093690.https://doi.org/10.1007/s40120-025-00733-xPersistent postural-perceptual dizzinessTranscranial magnetic stimulationDizziness handicap inventory |
| spellingShingle | Wenze Li Chang Liu Yuqing Zhang Maolin Peng Xiuhang Luo Hongfa Zhang Hairong Lan Zhipeng Li Yankun Chen Zhen Li Zhimin Xiao Linyan Tong Yangmei Chen Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial Neurology and Therapy Persistent postural-perceptual dizziness Transcranial magnetic stimulation Dizziness handicap inventory |
| title | Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial |
| title_full | Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial |
| title_fullStr | Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial |
| title_full_unstemmed | Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial |
| title_short | Efficacy and Safety Analysis of Repetitive Transcranial Magnetic Stimulation in Patients with Persistent Postural Perceptual Dizziness: A Single-Center, Single-Blind, Randomized Placebo-Controlled Trial |
| title_sort | efficacy and safety analysis of repetitive transcranial magnetic stimulation in patients with persistent postural perceptual dizziness a single center single blind randomized placebo controlled trial |
| topic | Persistent postural-perceptual dizziness Transcranial magnetic stimulation Dizziness handicap inventory |
| url | https://doi.org/10.1007/s40120-025-00733-x |
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