Mal de debarquement syndrome (MdDS) is a chronic disorder of imbalance 
characterized by a feeling of rocking and swaying. The medical treatment for 
MdDS is still limited. Motivated by our previous pilot study that demonstrates 
the promising clinical efficacy of repetitive transcranial stimulation (rTMS) in 
MdDS patients, a novel rTMS paradigm, i.e., 1 Hz stimulation over ipsilateral 
dorsal lateral prefrontal cortex (DLPFC) with respect to the dominant hand 
followed by 10 Hz stimulation over contralateral DLPFC, was proposed and 
conducted in MdDS in the present study. To evaluate the potential efficacy, we 
examined the changes before and after rTMS in both subjective reported symptom 
using visual analogue scale (VAS) and direct brain activity in resting state 
electroencephalography (rsEEG). To disentangle activity from distinct brain 
substrates and/or local networks in rsEEG signals, a group-wise independent 
component analysis was employed and the corresponding spectral power changes 
were examined in the identified components. In general, reduction in rocking 
sensation was reported in five of ten subjects (with dramatic reductions 
(changes > 30) in three subjects) after rTMS using the present paradigm, while 
no changes and slight increases in rocking sensation were reported in the 
remaining subjects. In rsEEG, significant elevated spectral powers in low 
frequency bands (i.e., theta and alpha) over broad areas of occipital, parietal, 
motor, and prefrontal cortices were induced by rTMS, reflecting the enhancement 
of cortical inhibition over these areas. Meanwhile, the significant correlations 
between changes in rsEEG and VAS scores were detected in the high frequency 
bands (i.e., high alpha and beta) over posterior parietal and left visual areas, 
reflecting the suppression of spatial information processing. Therefore, the 
present findings demonstrate the promising clinical efficacy of a new rTMS 
paradigm for MdDS, and suggest its merit for further studies in more patients.