{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:46:29Z","timestamp":1782279989598,"version":"3.54.5"},"reference-count":69,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82571311"],"award-info":[{"award-number":["82571311"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171159"],"award-info":[{"award-number":["82171159"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017962","name":"Jiangsu Commission of Health","doi-asserted-by":"publisher","award":["K2024079"],"award-info":[{"award-number":["K2024079"]}],"id":[{"id":"10.13039\/100017962","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018556","name":"Science and Technology Program of Suzhou","doi-asserted-by":"publisher","award":["SKY2023043"],"award-info":[{"award-number":["SKY2023043"]}],"id":[{"id":"10.13039\/501100018556","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Variable efficacy of repetitive transcranial magnetic stimulation (rTMS) for tinnitus necessitates predictive biomarkers. Pre-treatment brain structural features may predict rTMS outcomes, given that tinnitus involves structural brain alterations and rTMS can induce neuroplastic changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify pre-treatment brain structural biomarkers predictive of rTMS efficacy in subjective tinnitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled 64 patients with subjective tinnitus and 18 healthy controls (HCs). Patients underwent a 2-week course of rTMS. High-resolution T1-weighted structural MRI (sMRI) was acquired, and 242 whole-brain morphometric features were extracted. Univariate analysis identified features differing between responders and non-responders, which subsequently were used to construct a machine learning model evaluated via 5-fold cross-validation and SHapley Additive exPlanations (SHAP) analysis. Feature significance was further interpreted through three-group comparisons among responders, non-responders, and HCs. Spearman correlation analyses were performed between structural features and clinical improvement scores (\u0394VAS, \u0394THI) as well as baseline clinical measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-six patients (56.25%) were classified as responders. Ten regional features distinguished responders from non-responders, encompassing prefrontal, limbic, sensorimotor, and parietal networks. The predictive model (ExtraTreesGini_BAG_L1) achieved optimal performance (AUC = 0.85; accuracy = 0.77; precision = 0.71; recall = 0.97; F1-score = 0.82). SHAP analysis identified right pars triangularis of the inferior frontal gyrus (IFGtriang-R) gray matter volume (GMV) as the top predictor (positive influence). Three-group comparison revealed that IFGtriang-R GMV was significantly larger in responders (0.90 \u00b1 0.08) than in both HCs (0.86 \u00b1 0.06) and non-responders (0.86 \u00b1 0.07), indicating a specific structural signature associated with positive treatment outcome. Spearman correlation analyses revealed that IFGtriang-R volume did not significantly correlate with \u0394VAS or \u0394THI, and no structural feature showed a robust association with baseline clinical measures after Bonferroni correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Responders were characterized by relative enlargement of the IFGtriang-R, suggesting a threshold effect of neuroplastic reserve conducive to rTMS efficacy. Pre-treatment sMRI assessment of this region may facilitate patient stratification for rTMS treatment, advancing precision neuromodulation for tinnitus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1808769","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:49:57Z","timestamp":1782276597000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-treatment structural brain biomarkers predict response to repetitive transcranial magnetic stimulation in subjective tinnitus"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhongling","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Peng","sequence":"additional","affiliation":[{"name":"Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengfang","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxuan","family":"Qiu","sequence":"additional","affiliation":[{"name":"Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"He","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoting","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of 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