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

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Abstract
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.