Journal of International Psychiatry

Abstract: Objective: To investigate the effect of repetitive transcranial magnetic stimulation (RTMS) augmentation therapy on cognitive dysfunction in patients with chronic schizophrenia and its subsequent effect, and to explore the related factors affecting cognitive dysfunction. Methods: A total of 128 patients with schizophrenia were randomly divided into study group (true stimulation) and control group (sham stimulation), with 59 cases in each group. On the basis of taking the same type and dose of the original antipsychotic drugs, each group was given 20Hz true or sham rTMS on the corresponding left dorsolateral frontal cortex (DLPFC) for 4 weeks, 5 times a week. After the treatment, the patients were followed up for 3 months. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the psychiatric symptoms of the patients before and after treatment and after follow-up. Cognitive function was assessed by the Battery of neuropsychological tests (RBANS). Side effects were assessed by Barns Akathisia Scale. Repeated analysis of variance and simple effect analysis were used to compare the changes in clinical symptoms, cognitive function and side effects between the two groups. Person correlation analysis was used to analyze the correlation between baseline clinical symptoms and cognitive function. χ2 test was used to compare the effective rates between the two groups. Results: In terms of psychiatric symptoms, PANSS negative symptoms were negatively correlated with immediate memory, attention and delayed memory. Repeated measures analysis of variance showed that there were significant differences in the negative symptom scores of the two groups in different time main effects, group main effects and interaction effects of time and group. In terms of cognitive function changes, repeated measures analysis of variance showed that there were significant differences in the scores of immediate memory, attention and delayed memory between the two groups in different time main effects, group main effects and time and group interaction effects. After rTMS treatment (χ2=8.79, P=0.003) and follow-up (χ2=4.589, P=0.032), the improvement rate of the study group was statistically different from that of the control group. Conclusion: RTMS augmentation therapy can improve cognitive function, negative symptoms and other psychotic symptoms in patients with chronic schizophrenia to varying degrees, and shows a certain persistence. Psychotic symptoms such as negative symptoms may have some impact on the improvement of cognitive function.

Repetitive transcranial magnetic stimulation; Schizophrenia; Cognitive function