Schizophrenia-related abnormalities in the triple network: a meta-analysis of working memory studies

Previous meta-analyses found abnormal brain activations in schizophrenia patients compared with normal controls when performing working memory tasks. Although most studies focused on dysfunction of the working memory activation network in schizophrenia patients, deactivation abnormalities of the working memory in the default mode network have also been reported in schizophrenia but have received less attention. Our goal was to discover whether deactivation abnormalities can also be consistently found in schizophrenia during working memory tasks and, further, to consider both activation and deactivation abnormalities. Fifty-two English language peer-reviewed studies were included in this meta-analysis. Compared with normal controls, the schizophrenia patients showed activation dysfunction of the bilateral dorsolateral prefrontal cortex and posterior parietal cortex as well as the anterior insula, anterior cingulate cortex, and supplementary motor area, which are core nodes of the central executive and salience network. In addition to dysfunction of the activation networks, the patients showed deactivation abnormalities in the ventral medial prefrontal cortex and posterior cingulate cortex, which are core nodes of the default mode network. These results suggest that both activation and deactivation abnormalities exist in schizophrenia patients and that these abnormalities should both be considered when investigating the pathophysiological mechanism of schizophrenia.