Clinical baseline of the participants
Fouty-two participants were included in the final analysis after 2 participants were excluded from the control group for personal reasons. The baseline demographic and clinical characteristics of the participants did not differ between rTMS group and control group (p > 0.05). Precipitating illnesses of PPPD patients and their clinical status, medication use(Table 1).
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Clinical Outcomes
There was no significant difference in HAMA, HAMD and DHI scores between the two groups before treatment (P = 0.161, P = 0.047, and P = 0.162, respectively). HAMA, HAMD and DHI scores in the rTMS group were significantly different after 2 weeks compared to the control group (P = 0.047, P = 0.003, and P = 0.001, respectively), and the difference was more significant at 4 weeks of treatment than at 2 weeks of treatment (P = 0.000, P = 0.000, and P = 0.000, respectively). As shown in Table 2 and Fig. 2.
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Intergroup comparison of the rTMS group and control groups. As shown in Table 2 and Table 3. HAMD: There was no significance difference between the two groups at week 0 and 2(P = 0.329, P = 0.079, respectively). Significance was presented at 4 weeks (P = 0.000**). Specific analysis shows that: the two groups presented a 0.01 level of significance at 4 weeks (F = 23.737, P = 0.000), and specific comparison of differences shows that the mean of the control group (18.35), is significantly higher than the mean of the rTMS group (6.55). HAMA: There was no significance (P = 0.094) between the two groups at week 0. There was a difference between the two groups at 2 weeks and 4 weeks (P = 0.004**, P = 0.000**, respectively). Specific analysis: the two groups presented a 0.01 level of significance at 2 weeks (F = 9.375, P = 0.004), comparing the differences shows that the mean of the control group (23.45), was significantly higher than the mean of the rTMS group (13.91). At 4 weeks showed a 0.01 level of significance (F = 25.431, P = 0.000), comparing the differences shows that the mean of the control group (23.95), was significantly higher than the mean of the rTMS group (8.45). In conclusion: the two groups presented significant differences at 2 and 4 weeks. DHI: At 2 and 4 weeks showed significance (P = 0.003**, P = 0.000**, respectively). A specific analysis shows that the two groups of samples presented a 0.01 level of significance at 2 weeks (F = 10.328, P = 0.003) and the comparison shows that the mean of the control group (49.00) was significantly higher than the mean of the rTMS group (28.91). The samples of both groups presented a 0.01 level of significance at 4 weeks (F = 50.959, P = 0.000), and the comparison shows that the mean of the control group (44.60) was significantly higher than the mean of the rTMS group (11.45). In conclusion: the two groups of samples presented significant differences at 2 and 4 weeks.
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Logistic regression analysis with HAMA and HAMD scores as independent variables and DHI scores as dependent variables showed that HAMA and HAMD scores were positively correlated with DHI scores. The ORs corresponding to HAMA and HAMD scores were greater than 1 in both the rTMS group and control groups before, 2 weeks, and 4 weeks after treatment. The decrease in HAMA and HAMD scores contributes to the decrease in DHI scores (Tables 4).
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Correlation analysis showed that bivariate Pearson's test showed positive correlation between HAMD、HAMA scores and DHI scores after 2 weeks of treatment (rTMS group: r = 0.65, r = 0.75, Control group: r = 0.66, r = 0.64, P < 0.01). After 4 weeks of treatment, there was no correlation between HAMD scores and DHI scores in the rTMS group (r = 0.05, P > 0.05), HAMD scores were positively correlated with DHI scores in the Control group (r = 0.50, P < 0.05), and HAMA scores were positively correlated with DHI scores (rTMS group: r = 0.51, Control group: r = 0.47, P < 0.05). (Tables 5).
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No serious adverse events occurred during the total course of treatment. Among all patients who completed treatment, two patients in the rTMS group experienced minor headaches, discomfort at the site of scalp irritation, and two patients in the control group experienced minor headaches, and four patients had symptoms that disappeared after rest and were not given special treatment(p > 0.05). (Tables 6).
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