Frontal GABA in schizophrenia: A meta-analysis of <sup>1</sup>H-MRS studies
Vijay Kumar, Bhavika Vajawat, Naren P. Rao
Abstract
Objectives The primary objective was to conduct a meta-analysis of studies comparing the GABA levels of schizophrenia patients (SZP) and healthy controls (HC) using proton magnetic resonance spectroscopy (1H-MRS) in the frontal cortex (FC) and its sub-regions.Methods We included studies published in English language that used 1H-MRS from MRI scanners having at-least 3 Tesla (3 T) magnetic field strength to measure GABA levels in SZP (n = 699) and HC (n = 718) in FC and its sub-regions. The outcome measures were the means and standard deviations of GABA levels and outcome measure was calculated using a random-effect model.Results In FC, medial prefrontal cortex (MPFC) and dorsolateral prefrontal cortex (DLPFC), there were no significant group differences. On excluding the outlier studies, the GABA levels were lower in patients with schizophrenia compared to healthy controls in FC (Hedges’ g = −0.2; p = 0.02). In ACC, significant group difference was noted in GABA levels (Hedges’ g = −0.25; p = 0.03) with patients values being lower that is more pronounced in the first episode schizophrenia patients (Hedges’ g: −0.41; p = 0.003).Conclusions The available 1H-MRS studies suggest hypo-GABA ergia specifically in ACC and hint towards possible hypo GABA-ergic state in the FC. However, limitations of the analysis should be considered while interpreting the results.