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Hypofrontality in schizophrenia: a meta-analysis of functional imaging studies

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Hill K, Mann L, Laws KR, Stephenson CME, Nimmo-Smith I, McKenna PJ. Hypofrontality in schizophrenia: a meta-analysis of functional imaging studies.

Acta Psychiatr Scand 2004: 110: 243–256. © Blackwell Munksgaard 2004. 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. Resting 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.

Keywords: frontal lobe; functional imaging; schizophrenia

Document Type: Research Article


Affiliations: 1: Fulbourn Hospital, Cambridge 2: Department of Psychology, Nottingham Trent University, Nottingham 3: Department of Psychiatry, University of Cambridge, Brain Mapping Unit, Addenbrooke's NHS Trust, Cambridge 4: MRC Cognition and Brain Sciences Unit, Cambridge, UK

Publication date: October 1, 2004


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