Functional connectivity of the striatum in psychosis: Meta-analysis of functional magnetic resonance imaging studies and replication on an independent sample

Neuroimaging studies have shown that striatal functional connectivity (FC) is altered in psychosis (PSY). However, the evidence remains heterogeneous, partly due to the different subregions and clinical stages considered. For this reason, we gathered available studies that evaluated FC between the striatum and the whole brain in PSY through systematic research of the literature. Then, we performed a coordinate-based activation meta-analysis of brain regions that showed dysconnectivity with the striatum to identify spatially convergent patterns (40 experiments, 4473 subjects). The analysis was replicated for the experiments including only individuals with schizophrenia, first-episode psychosis (FEP), and drug-naïve FEP, and assessing the FC of the limbic and associative striatum. Lastly, we analyzed an independent sample to assess the relationship between these changes and clinical and cognitive variables. In PSY, the striatum was hypoconnected with the anterior cingulate cortex/medial prefrontal cortex (replicated in all analyses and in the independent sample, where the FC was correlated with cognitive flexibility), and with the right thalamus, while it was hyperconnected with the right caudate and the left middle frontal gyrus. These findings of specific patterns of striatal dysconnectivity in PSY could improve our understanding of the role of the striatum in pathophysiology and provide potential biomarkers and targets for new treatments.