Dual-Site Transcranial Magnetic Stimulation of the Supplementary Motor Area and Cerebellum for the Treatment of Essential Tremor.

Inclusion Criteria: * Male or female participants, aged 18 to 80 years; women of childbearing potential must not be pregnant. * Diagnosis of Essential Tremor with a score greater than 2 on items 5 or 6 of the Fahn-Tolosa-Marin Tremor Rating Scale despite optimized medical therapy. * Medication-refractory tremor, defined as prior use of both first-line medications (propranolol and primidone) at maximally tolerated doses without adequate tremor control. * Ability to provide written informed consent in accordance with institutional policies. * Ability to comply with all study procedures and follow-up assessments as defined by the study protocol. Exclusion Criteria: * Unstable or untreated psychiatric disorders. * Inability to provide informed consent. * Uncontrolled medical conditions, including but not limited to uncontrolled diabetes mellitus, hypertension, symptomatic pulmonary disease, or symptomatic cardiac disease. * Concomitant participation in another investigational drug or device study. * Pregnancy or breastfeeding. * Presence of an implanted deep brain stimulation (DBS) system. * History of epilepsy not adequately controlled, defined as seizure-free for less than 5 years. * Presence of a cardiac pacemaker. * Presence of metallic implants in any part of the body that are contraindicated for rTMS.