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Frontal GABA in schizophrenia: A meta-analysis of 1H-MRS studies
Vijay Kumar1, Bhavika Vajawat1, Naren P Rao1
1Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
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.
