Effect of repetitive transcranial magnetic stimulation on vestibular function and self-rated functional recovery in patients with peripheral vestibular dysfunction: a controlled clinical trial

Introduction Most patients with vestibular dysfunction have balance disorders and vertigo, which may have a negative impact on the activities of daily living. This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (TMS) on functional recovery in these patients. Methods Thirty-five patients with unilateral peripheral vestibular dysfunction participated in this study. This study used a prospective randomised controlled trial design, and the randomisation was 1:1. They were randomly assigned to experimental and control groups; the experimental group, which consists of eighteen patients, received repetitive transcranial magnetic stimulation plus conventional physical therapy treatment in the form of Cawthorne-Cooksey exercises, while the control group, which consists of seventeen patients, received only conventional physical therapy treatment. The interventions in the two groups were conducted in three sessions every week for four consecutive weeks. The primary outcome measure was videonystagmography. The chi-squared and a mixed-design 2 × 2 MANOVA test were used to compare differences in variables for evaluating baseline and post-treatment changes. Results The experimental group showed a significant improvement in canal weakness (66.26%) with a <i>p</i> < 0.001, DHI (77.21%) with a p-value of 0.001, and VADL (70.85%) with a p-value of 0.003 as compared to the controls. The control group showed significant improvements only in the DHI (44.45%) and VADL (33.05%) compared to the baseline, and the effect size <i>f</i>2 (<i>V</i>) = 0.66 was calculated for the independent canal weakness variable. Conclusions The addition of repetitive transcranial magnetic stimulation to Cawthorne-Cooksey exercises could improve the outcomes of vestibular and self-rated functional recovery.