Ye Suzhen, Wang Bailing, Sui Heling, Xiu Meihong, Wu Fengchun
Department of Rehabilitation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Qingdao Mental Health Center, Qingdao, China.
Schizophrenia (Heidelb). 2025 Mar 10;11(1):41. doi: 10.1038/s41537-025-00590-5.
rTMS has shown some effect in improving cognitive functions in patients with schizophrenia. However, these findings were controversial, and specific mechanisms of action and optimal therapeutic parameters still require further investigation. This study aimed to examine predictive biomarkers of the efficacy of rTMS in cognitive improvement in schizophrenia. A secondary analysis of a previous randomized, controlled trial was performed. Fifty-six patients were allocated to the active rTMS and 28 to the sham group. Patients received 6 weeks of treatment and were followed up for 18 weeks. Cognition was assessed and blood biomarkers were measured in all patients. In patients with schizophrenia, there was a significant interaction between time and group on immediate memory. Furthermore, this study found that after controlling for confounders, patients with higher baseline white blood cell (WBC) counts showed less improvement in immediate memory after rTMS than patients with lower WBC counts. Linear regression analysis showed that WBC counts were associated with immediate memory improvement after rTMS treatment. Our results reveal that WBC counts at baseline correlated with the response to rTMS in patients with schizophrenia. Patients with higher baseline WBC counts improved less after rTMS intervention than those with lower WBC counts.
重复经颅磁刺激（rTMS）已显示出对改善精神分裂症患者认知功能有一定效果。然而，这些研究结果存在争议，其具体作用机制和最佳治疗参数仍需进一步研究。本研究旨在探讨rTMS改善精神分裂症患者认知功能疗效的预测生物标志物。对之前一项随机对照试验进行了二次分析。56例患者被分配至rTMS治疗组，28例患者被分配至假刺激组。患者接受6周治疗，并随访18周。对所有患者进行认知评估并检测血液生物标志物。在精神分裂症患者中，时间和组间在即时记忆方面存在显著交互作用。此外，本研究发现，在控制混杂因素后，基线白细胞（WBC）计数较高的患者在rTMS治疗后即时记忆的改善程度低于WBC计数较低的患者。线性回归分析表明，WBC计数与rTMS治疗后即时记忆的改善相关。我们的结果显示，精神分裂症患者的基线WBC计数与对rTMS的反应相关。基线WBC计数较高的患者在rTMS干预后的改善程度低于WBC计数较低的患者。
