Objective To investigate the relationship between morphometric parameters of the cerebral cortex and the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of tardive dyskinesia (TD).

Methods A total of 105 schizophrenic patients with TD undergoing basic treatment were enrolled, and randomly divided into group A (n=35), group B (n=35) and group C (n=35). Group A received rTMS at 1 Hz, group B received rTMS at 10 Hz, and group C received sham stimulation. All groups were treated for 12 weeks. The severity of TD was assessed using the Abnormal Involuntary Movement Scale (AIMS) before and after treatment. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Positive and Negative Syndrome Scale (PANSS) in Chinese were used to evaluate patients' neuropsychological status and symptom severity. magnetic resonance imaging (MRI) was employed to scan the left prefrontal cortex of patients to obtain parameters of cortical thickness, surface area and volume. Pearson correlation analysis was used to analyze the relationship between cortical morphological parameters and the efficacy of rTMS for TD in patients.

Results After treatment, AIMS scores in the three groups were significantly lower than before treatment, and the group A was significantly lower than the group B and group C (P < 0.05). After treatment, RBANS scores were significantly higher and PANSS scores were significantly lower in three groups than before treatment (P < 0.05). After treatment, the RBANS score of the group A was significantly higher than that of the group B and group C, and the group B was significantly higher than the group C (P < 0.05); the PANSS score of the group A was significantly lower than that of the group B and group C, and the group B was significantly lower than the group C (P < 0.05). After treatment, cortical morphological parameters (cortical thickness, surface area and volume) in the group A and group B were significantly higher than before treatment, and the group A was significantly higher than the group B (P < 0.05). The therapeutic effect of the group A was positively correlated with cortical thickness, surface area and volume (P < 0.05).

Conclusion The morphometric parameters of the left prefrontal cortex are associated with the efficacy of rTMS in treating TD. The rTMS at 1 Hz can facilitate structural remodeling of the motor cortex, thereby improving treatment outcomes for TD patients.