Baseline Prolactin Predicts High-Frequency Repetitive Transcranial Magnetic Stimulation Response on Immediate Memory in Schizophrenia.

Abstract

Introduction: The therapeutic effects of rTMS may be mediated, at least in part, by the neuroendocrine mechanism. The present study was designed to investigate whether baseline hormone concentrations predict clinical response to rTMS in schizophrenia.

Methods: This is a secondary analysis of 84 patients with schizophrenia enrolled in a previously published randomized, sham-controlled trial. All participants completed 30 sessions of highfrequency rTMS applied to the left dorsolateral prefrontal cortex. We assessed cognitive functioning before and after prefrontal rTMS intervention. Blood hormone levels were determined in the hospital laboratory.

Results: High-frequency rTMS showed a significant improvement in immediate memory relative to sham. At baseline, there was no difference in hormone levels between the real and sham rTMS groups. However, baseline prolactin (PRL) levels were positively associated with rTMS efficacy in the real rTMS group, and patients with higher baseline PRL levels showed greater improvement in immediate memory than those with lower levels. Linear regression analysis adjusting for age, symptom severity, baseline immediate memory, antipsychotic dosage, and types revealed that PRL at baseline was a predictor of the response to rTMS in patients with schizophrenia. No other hormone predicted cognitive outcome.

Discussion: Our findings suggest a potential role for PRL levels in predicting rTMS efficacy, particularly in improving immediate memory in patients with schizophrenia, providing further evidence for the individualisation of future rTMS treatments.

Conclusions: Our findings suggest a potential role for PRL levels in predicting rTMS efficacy, particularly in improving immediate memory in patients with sc.