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Meta-analysis of Brain Volumes in Unaffected First-Degree Relatives of Patients With Schizophrenia Overemphasizes Hippocampal Deficits
Colm McDonald, MB, PhD, MRCPsych;
Brendan Dineen, MPH;
Brian Hallahan, MD, MRCPsych
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We read with interest the important meta-analysis of brain volumes in unaffected first-degree relatives of patients with schizophrenia by Boos and colleagues.1 Given the highly influential status of meta-analysis in the hierarchy of evidence, methodological rigor in carrying out a meta-analysis is paramount. However, we note several apparent errors and question the authors' conclusion that brain abnormalities in such relatives are "most pronounced in the hippocampus."
The number of subjects contributing data for the total hippocampal volume meta-analysis is overestimated as reported in the forest plot of effect sizes in relatives compared with controls (Figure 1 in the Boos et al article). First, the authors include as relatives all the "ultra high-risk" subjects from Wood et al.2 However, most of these subjects were not relatives of a patient with psychotic illness at all but rather had an "at-risk . . . [Full Text of this Article]
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Brain Volumes in Relatives of Patients With Schizophrenia: A Meta-analysis
Heleen B. M. Boos, André Aleman, Wiepke Cahn, Hilleke Hulshoff Pol, and René S. Kahn
Arch Gen Psychiatry. 2007;64(3):297-304.
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Meta-analysis of Brain Volumes in Unaffected First-Degree Relatives of Patients With Schizophrenia Overemphasizes Hippocampal Deficits—Reply
Heleen B. M. Boos, André Aleman, Wiepke Cahn, Hilleke Hulshoff Pol, and René S. Kahn
Arch Gen Psychiatry. 2008;65(5):604-605.
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