Hypofrontality in Schizophrenia. A meta-analysis of functional imaging studies
Hill, K.; Mann, L.; Laws, K.R.; Stephenson, C. M. E.; Nimmo-Smith, I.; McKenna, P. J.
Citation: Hill , K , Mann , L , Laws , K R , Stephenson , C M E , Nimmo-Smith , I & McKenna , P J 2004 , ' Hypofrontality in Schizophrenia. A meta-analysis of functional imaging studies ' Acta Psychiatrica Scandinavica , vol 110 , no. 4 , pp. 243-256 . , 10.1111/j.1600-0447.2004.00376.x
Objective: Hypofrontality is not a well-replicated finding in schizophrenia either at rest or under conditions of task activation. Method: Studies comparing whole brain and frontal blood flow/ metabolism in schizophrenic patients and normal controls were pooled.Voxel-based studies were also combined to examine the pattern of prefrontal activation in schizophrenia. Results: Whole brain flow/metabolism was reduced in schizophrenia to only a small extent.Restin g and activation frontal flow/metabolism were both reduced with a medium effect size.Duration of illness significantly moderated resting hypofrontality, but the moderating effects of neuroleptic treatment were consistent with an influence on global flow/metabolism only.Pooling of voxel-based studies did not suggest an abnormal pattern of activation in schizophrenia. Conclusion: Meta-analysis supports resting hypofrontality in schizophrenia.Task-activated hypofrontality is also supported, but there is little from voxel-based studies to suggest that this is associated with an altered pattern of regional functional architecture.
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