To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with vestibular rehabilitation training (VRT) for persistent postural-perceptual dizziness (PPPD).

In this retrospective case-control study, 48 PPPD patients admitted to our rehabilitation center (September 2023 to September 2024) were divided into control group (n=24, VRT only) and study group (n=24, VRT + rTMS). Assessments at baseline and post-treatment included Dizziness Handicap Inventory (DHI), Vestibular Symptom Index (VSI), Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), Numeric PPPD Questionnaire (NPQ), and overall response rate.

After 6 weeks, the study group showed significantly higher overall response rate compared to control group (91.67% vs 66.67%, P=0.033). The study group demonstrated significantly lower scores than control group: DHI (37.85±6.46 vs 48.53±7.54, P=0.007), VSI (3.85±0.46 vs 5.53±1.54, P=0.002), HAMD (10.20±6.30 vs 15.74±7.05, P=0.006), PSQI (6.24±1.88 vs 8.89±2.79, P=0.003), and NPQ (15.44±3.26 vs 20.81±9.14, P=0.009).

‍Combined low-frequency rTMS and VRT effectively alleviates dizziness symptoms and improves treatment efficacy in PPPD patients.