Age as a moderator of rTMS efficacy on cognitive function in schizophrenia: a randomized controlled trial

This study aimed to examine the efficacy of rTMS on cognitive functions in younger and older male patients with schizophrenia, and to explore the clinical significance of age as a potential moderator of treatment response.

A total of 84 subjects with schizophrenia were recruited and randomly assigned to receive six weeks of active rTMS or sham rTMS treatment. Participants were categorized into younger (≤54 years) and older (>54 years) groups. Cognitive functioning was assessed at baseline, the 2nd, 6th, and at the end of the 24th week.

Older patients showed worse performance in cognitive functions than younger patients. There was a significant interaction between treatment time and group on immediate memory and total scores in younger and older patients after six weeks of rTMS treatment (all p < 0.05). Further analysis showed younger patients exhibited greater improvements in immediate memory (F = 2.8, p = 0.04) and delayed memory (F = 3.3, p = 0.02) compared to older patients. Moreover, linear regression analysis supported that age was a significant factor influencing the therapeutic response to rTMS intervention.

The study highlights the clinical significance of age as a moderator of rTMS efficacy in schizophrenia. While rTMS can enhance cognitive functions in both age groups, younger patients demonstrate more pronounced improvements, likely due to higher neuroplasticity.