Searching the schizophrenic brain for temporal lobe deficits: a systematic review and meta-analysis

BACKGROUND: Several empirical studies have found temporal lobe impairments in many patients with schizophrenia. The strength and consistency of this evidence, however, has not been evaluated and synthesized quantitatively. Hence, we ask to what extent are temporal cortices really defective in schizophrenia? METHODS: Meta-analytical methods were used to determine the magnitude of evidence in support of structural and physiological temporal-hippocampal system deficits in schizophrenia. We report effect sizes from studies since 1980 that used structural (CT, MRI) and functional (SPECT, PET) neuroimaging methods. RESULTS: Both structural and functional imaging literatures are distinguished by heterogeneity whereby most patients show normative temporal function and structure, a minority shows diminished values and some patients demonstrate augmented function and structure rather than a deficit. CONCLUSIONS: The findings are hard to incorporate within single disease models that propose major involvement of the temporal system in schizophrenia, at least at the degree of resolution obtained with current imaging technology.