Neurology and Therapy最新文献

{"title":"Incidence and Prevalence of Juvenile Myasthenia Gravis in the United States Between 2010 and 2020: Analysis of Two Claims Databases.","authors":"Jiachen Zhou, Anna Kuba, Sigrid Nilius, Olga Pilipczuk, Thaïs Tarancón, Frank Tennigkeit","doi":"10.1007/s40120-025-00750-w","DOIUrl":"10.1007/s40120-025-00750-w","url":null,"abstract":"<p><strong>Introduction: </strong>Few published population-based studies report the incidence or prevalence of juvenile myasthenia gravis (JMG) due to the rarity of the disorder. Despite recent progress in new targeted treatments and ongoing developments, there remains a critical need for novel and effective therapies specifically for JMG. Most treatments used for JMG are only approved for adult patients with MG. Thus, a thorough evaluation and understanding of the basic epidemiology of JMG is needed.</p><p><strong>Methods: </strong>We conducted a population-based retrospective study to estimate the annual incidence and prevalence of JMG in the US from 2010 to 2020 by analyzing the Merative™ MarketScan^® Commercial Claims and Encounters Database (CCAE) and Multi-State Medicaid Database (MDCD).</p><p><strong>Results: </strong>The incidence of JMG in 2020 was 5.9 [95% confidence interval (CI) 3.3-9.7] per million person-years in CCAE and 8.7 (95% CI 6.0-12.3) per million person-years in MDCD, with considerable variation across the study period. The prevalence of diagnosed JMG remained fairly consistent, with 25.3 (95% CI 19.9-32.2) per million population in CCAE and 37.6 (95% CI 31.9-44.4) per million population in MDCD in 2020. Both databases consistently showed higher incidence and prevalence among girls compared with boys. No clear pattern was observed in incidence by age of onset over the study period, whereas prevalence generally increased with age. Both incidence and prevalence by age of onset were higher in MDCD than CCAE. Furthermore, higher incidence and prevalence were observed among Black population compared with White population. Overall, no obvious increasing or decreasing trend was observed during the study period.</p><p><strong>Conclusion: </strong>The incidence and prevalence of JMG in the US, previously understudied, may be higher than earlier research suggested, possibly due to limited research into the epidemiology of JMG. This finding implies that the actual burden of JMG could be greater than previously estimated.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1093-1103"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monthly Headaches and Severity in Patients on Galcanezumab or Traditional Preventive Migraine Medication: A 24-Month Claims and Electronic Health Records Study.","authors":"Oralee J Varnado, Michelle Vu, Gilwan Kim, Margaret Hoyt, Erin Buysman, Abhinav Nayyar, Shikha Anand, Lars Viktrup","doi":"10.1007/s40120-025-00742-w","DOIUrl":"10.1007/s40120-025-00742-w","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine, affecting millions globally, imposes a significant burden on patients and healthcare systems. Calcitonin gene-related peptide monoclonal antibodies are recommended as first-line preventive treatments by international guidelines, yet real-world prospective studies comparing their year-long effectiveness to standard of care (SOC) treatments are time-consuming, resource-intense and therefore limited. This study aimed to test the utility of claims data and electronic health records (EHR) by evaluating changes in monthly headache days (MHDs) and disease severity among US patients with migraine receiving galcanezumab versus traditional standard-of-care preventive migraine medications.</p><p><strong>Methods: </strong>A real-world study was conducted using Optum data from US administrative claims and EHR of patients diagnosed with migraine and receiving galcanezumab or SOC. Changes in MHDs over a 24-month follow-up were converted from changes in acute medication using the Pharmacy Quality Alliance (PQA) measure for Migraine Preventive Therapy, and migraine severity was assessed using EHR free text. Data were analyzed using two-sample t-test, chi-square and Fisher exact tests.</p><p><strong>Results: </strong>Of 63,939 patients with eligible claims, 28,264 (44.2%) had notes in EHR; of those, 227 and 65 patients had information for migraine severity and headache days, respectively. Patients receiving galcanezumab showed significant improvement in MHDs compared to the SOC cohort when assessed using PQA measures (mean [SD] change from baseline to follow-up, - 0.18 [4.76] vs 0.15 [3.85]; p < 0.001). A significantly greater proportion of patients treated with galcanezumab exhibited a 50% reduction (25.9% vs 16.7%; p < 0.001) and 75% reduction (15.7% vs 11.6%; p < 0.001) in MHDs than the standard-of-care cohort. Mean change in migraine severity and MHDs was not determined by EHR because of low sample sizes.</p><p><strong>Conclusion: </strong>In this exploration of multiple data sources and methodologies, changes in MHDs over 24 months were small in patients treated with galcanezumab or SOC. While real-world data from administrative claims and EHR provided insights, limitations such as small sample sizes for migraine severity data and challenges in extracting clinical outcomes underscore the need for further research.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"911-925"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding: Quantitative Analysis of White Matter Hyperintensities as a Predictor of 1‑Year Risk for Ischemic Stroke Recurrence.","authors":"E Zhao, Zhengting Duan, Jingmei Li","doi":"10.1007/s40120-025-00718-w","DOIUrl":"10.1007/s40120-025-00718-w","url":null,"abstract":"","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1151-1153"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor Regarding: Quantitative Analysis of White Matter Hyperintensities as a Predictor of 1-Year Risk for Ischemic Stroke Recurrence.","authors":"Yi Sun, Hao Wang","doi":"10.1007/s40120-025-00719-9","DOIUrl":"10.1007/s40120-025-00719-9","url":null,"abstract":"","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1155-1156"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Treatment Patterns of Chorea in North American Patients with Huntington's Disease: Data from Enroll-HD.","authors":"Erin Furr Stimming, Daniel O Claassen, Ginny P Sen, Olga Klepitskaya, Michael Serbin, Hyunwoo Kim, Sean C Hinton, Dietrich Haubenberger","doi":"10.1007/s40120-024-00703-9","DOIUrl":"10.1007/s40120-024-00703-9","url":null,"abstract":"<p><strong>Introduction: </strong>Chorea is the primary manifestation of Huntington's disease. Different clinicians pursue varied approaches to chorea management, and real-world evidence describing them is needed. The objective of this study was to assess the presence and severity of chorea, chorea pharmacotherapy, and treatment practice, and patterns in a large natural-history cohort with Huntington's disease.</p><p><strong>Methods: </strong>The Enroll-HD research platform Periodic Dataset 5.0 was used to select subjects. Outcomes included demographics, disease-related baseline characteristics (Primary Analysis Set), and treatment patterns (Treatment Analysis Set).</p><p><strong>Results: </strong>A total of 2590 manifest participants comprised the Primary Analysis Set with 1040 in the Treatment Analysis Set; 96.8% of participants had chorea. Mean Unified Huntington's Disease Rating Scale scores for Total Maximal Chorea, Total Motor Score, and Total Functional Capacity were 9.6, 39.5, and 7.8, respectively. During the observation period from June 2012 to October 2020, 906 (36.1%) participants received treatment for chorea. Among these, the most common first-line therapies were monotherapy VMAT2 inhibitors (49.9%) and antipsychotics (27.7%), while 7.8% of participants discontinued first-line therapy. Of those receiving VMAT2 inhibitors or antipsychotics as first line, 92% and 84%, respectively, remained on VMAT2 inhibitors or antipsychotics alone or in combination for the duration of the study. The most common second-line treatment was combination therapy.</p><p><strong>Conclusions: </strong>Only 36.1% of participants with chorea were taking a medication indicated for chorea, and, while 49.9% of treated participants received VMAT2 inhibitors first-line, approximately half were prescribed off-label alternatives. It is unclear why patients with indications for treatment were untreated or why off-label alternatives were prescribed. Future research should elaborate on these observations.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"743-756"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopause, Perimenopause, and Migraine: Understanding the Intersections and Implications for Treatment.","authors":"Marta Waliszewska-Prosół, Giovanni Grandi, Raffaele Ornello, Bianca Raffaelli, Marcin Straburzyński, Claudio Tana, Paolo Martelletti","doi":"10.1007/s40120-025-00720-2","DOIUrl":"10.1007/s40120-025-00720-2","url":null,"abstract":"<p><p>Migraine affects women three times more often than it does men, and various mechanisms may explain this incidence, including the key role of female sex hormones. Fluctuations in the levels of these hormones and their feedback control regulate the menstrual cycle, pregnancy, puerperium, perimenopause, and menopause. They can influence the occurrence and severity of migraine throughout the reproductive period. Of particular importance seems to be the perimenopausal period, which is associated with an increase in migraine, especially menstrual migraine, which is considered more disabling and less amenable to treatment than non-menstrual attacks. This article reviews the available evidence documenting the relationship between perimenopause, menopause, and migraine and diagnostic considerations in an attempt to determine the management of these periods of a woman's life. Special considerations, future directions, and unmet needs for perimenopausal and menopausal migraine are also discussed.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"665-680"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudoscan in ATTRv Amyloidosis: A Potential Marker of Disease Progression?","authors":"Angela Romano, Valeria Guglielmino, Francesca Vitali, Maria Ausilia Sciarrone, Giovanni Siconolfi, Andrea Di Paolantonio, Guido Primiano, Marco Luigetti","doi":"10.1007/s40120-025-00721-1","DOIUrl":"10.1007/s40120-025-00721-1","url":null,"abstract":"<p><strong>Introduction: </strong>Hereditary transthyretin amyloidosis (ATTRv amyloidosis) is a severe, autosomal dominant disease resulting from multisystemic extracellular deposition of amyloid fibrils, leading to progressive organ damage and death. Sudoscan is a reproducible tool investigating sweat gland function and, indirectly, small nerve fiber impairment. The aim of this study was to evaluate any changes over time in electrochemical skin conductance (ESC) measured by Sudoscan in a cohort of late-onset patients with ATTRv from a single Italian center. Additionally, we investigated the role of Sudoscan as a marker of disease severity to confirm previous literature data.</p><p><strong>Methods: </strong>We enrolled 61 patients with a late-onset ATTRv amyloidosis harboring different TTR variants with at least one clinical and instrumental evaluation including Sudoscan. Correlations with clinical data (including both clinical scales and questionnaires) were investigated to confirm the role of Sudoscan as a marker of disease severity. Moreover, a longitudinal analysis was performed in the subgroup of patients with at least 4 complete yearly evaluations (n = 23) to assess the role of Sudoscan as a marker of disease progression.</p><p><strong>Results: </strong>At each yearly assessment, ESC values from both feet and hands significantly correlated with disease duration and neuropathy severity, as assessed by common clinical scales and questionnaires. No correlation was found with age at evaluation. Moreover, we observed a statistically significant change over time in ESC values measured at the feet (fESC) but not at the hands (hESC).</p><p><strong>Conclusions: </strong>Sudoscan may represent a reliable marker of dysautonomia in ATTRv amyloidosis, displaying a potential role as a marker of both disease severity and progression. It could, therefore, serve as an outcome measure in future clinical trials. In addition, feet ESC seems to be a significant, independent predictor of autonomic dysfunction.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"787-800"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapies for Advanced Parkinson's Disease in Sweden: A Cost-Effectiveness Analysis Using Real-World Data.","authors":"Dag Nyholm, Simon Eggington, Astrid Holm","doi":"10.1007/s40120-025-00730-0","DOIUrl":"10.1007/s40120-025-00730-0","url":null,"abstract":"<p><strong>Introduction: </strong>The Swedish Parkinson's Disease (PD) Registry provides rich data on cost and quality of life for patients receiving device-aided therapies (DATs) for Parkinson's disease in Sweden. This study sought to use this real-world evidence to determine the cost-effectiveness profile of specific DATs in Sweden.</p><p><strong>Methods: </strong>We developed a state transition (Markov) model to represent disease progression over time and used published clinical data to represent short- and long-term disease outcomes. We used data from the Swedish PD Registry to assign costs and quality of life measures (utilities) to each health state and modelled total costs and outcomes over a 20-year time horizon. The four treatment groups modelled were: best medical therapy, deep brain stimulation, levodopa-carbidopa intestinal gel, and continuous subcutaneous apomorphine infusion. We calculated results from both payer and societal perspectives.</p><p><strong>Results: </strong>The most cost-effective intervention was deep brain stimulation (DBS), which dominated all other interventions. Sensitivity analysis indicated that the key drivers of uncertainty were the transition probabilities between successive Hoehn and Yahr stages on each treatment. Results were consistent from both payer and societal perspectives.</p><p><strong>Conclusion: </strong>DBS is a cost-effective use of resources in Sweden. However, uncertainty remains regarding long-term symptom control as well as quality of life within specific health states for all device-aided therapies, and further data are needed to fully validate the model projections and provide more insight into areas of future research.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"801-812"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mediating Effect of Intracranial Hemorrhage Status on the Relationship between the INR and Mortality in Patients with Ischemic Stroke.","authors":"Yapeng Guo, Lingshan Wu, Zhenxuan Tian, Xu Xu, Jinfu Ma, Changwei Guo, Linyu Li, Jie Yang, Wenjie Zi, Jiacheng Huang, Xianjun Huang","doi":"10.1007/s40120-025-00715-z","DOIUrl":"10.1007/s40120-025-00715-z","url":null,"abstract":"<p><strong>Introduction: </strong>The international normalized ratio (INR) is a biomarker of coagulopathy. The objective of this study was to assess the relationship between the INR and clinical outcomes in patients with large vessel occlusion (LVO) stroke who received endovascular therapy.</p><p><strong>Methods: </strong>The RESCUE BT trial was a multicenter, randomized, double-blind, placebo-controlled clinical trial involving 948 stroke patients from 55 centers across China. We extracted INR data and related data from the BT database, with outcome measures comprising intracranial hemorrhage (ICH) and 90-day mortality. Logistic regression analysis was conducted to examine the associations between the INR and clinical outcomes in the entire patient cohort and across different stratified subgroups.</p><p><strong>Results: </strong>A total of 885 patients met the study criteria, with 672 exhibiting a normal INR and 213 showing an elevated INR. Multivariable analysis indicated that an elevated INR was linked to an increased risk of ICH (OR 1.65, 95% confidence interval CI 1.17-2.33, P =0.005) and 90-day mortality (OR 1.78, 95% CI 1.17-2.70, P =0.007). Mediation analysis indicated that the association between the INR and 90-day mortality risk was partially mediated by ICH status, with the mediation effect contributing 11.4% to the overall relationship. Subgroup analyses revealed no significant differences between the different subgroups (P for interaction > 0.05). In patients receiving tirofiban, an elevated INR was more strongly associated with an increased 90-day mortality rate (OR 7.75, 95% CI 1.42-42.33, P =0.018).</p><p><strong>Conclusion: </strong>Our findings underscore the critical importance of INR monitoring in patients with LVO stroke undergoing endovascular treatment (EVT). The association between the INR and 90-day mortality was mediated through ICH status. The use of tirofiban strengthened the associated between an elevated INR and a higher 90-day mortality rate. These insights offer valuable guidance for optimizing patient outcomes.</p><p><strong>Trial registration: </strong>URL: http://www.chictr.org.cn ; ChiCTR-INR-17014167.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"881-894"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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.","authors":"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","doi":"10.1007/s40120-025-00733-x","DOIUrl":"10.1007/s40120-025-00733-x","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, CTR2400093690.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"849-863"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}