Moderating role of familial relationships in the efficacy of rTMS intervention on cognitive function in patients with schizophrenia.

Background: It has been hypothesized that rTMS improves cognitive performance in SCZ by altering neuronal activity through magnetic field pulses. However, these findings were controversial. The present study examined whether familial relationships impacted the effect of rTMS targeting the left DLPFC on cognitive function improvement in patients with SCZ.

Methods: A total of 84 SCZ patients were randomly allocated to the active rTMS or sham rTMS groups and received a 6-week intervention session. Patients were followed up at the end of the 24th week. Cognitive functions were evaluated at baseline and at the end of the 2nd, 6th, and 24th weeks. Patients' relationships with their family members were also evaluated.

Results: Significant interactions of time × treatment on immediate memory and total scores were observed in patients with SCZ treated with rTMS. Active rTMS stimulation showed a beneficial effect on immediate memory in SCZ. In addition, we found that after controlling for confounding factors, patients with positive familial relationships experienced greater improvements in immediate memory after rTMS than those with negative relationships. More importantly, linear regression analysis revealed that familial relationship was a predictor of immediate memory improvement following rTMS intervention.

Conclusions: Our results reveal that familial relationships significantly influence the outcome of rTMS treatment in patients with SCZ. Relative to patients with negative familial relationships, those with positive relationships showed greater cognitive improvement.

Trial registration: ClinicalTrials.gov, NCT03774927, registered on 20,181,211.