In the past years, ample interest in brain abnormalities related to clinical and cognitive insight in psychosis has contributed several neuroimaging studies to the literature. In the current study, published findings on the neural substrates of clinical and cognitive insight in psychosis are integrated by performing a systematic review and meta-analysis.

Coordinate-based meta-analyses were performed with the parametric coordinate-based meta-analysis approach, non-coordinate based meta-analyses were conducted with the metafor package in R. Papers that could not be included in the meta-analyses were systematically reviewed.

Thirty-seven studies were retrieved, of which 21 studies were included in meta-analyses. Poorer clinical insight was related to smaller whole brain gray and white matter volume and gray matter volume of the frontal gyri. Cognitive insight was predominantly positively associated with structure and function of the hippocampus and ventrolateral prefrontal cortex.

Impaired clinical insight is not associated with abnormalities of isolated brain regions, but with spatially diffuse global and frontal abnormalities suggesting it might rely on a range of cognitive and self-evaluative processes. Cognitive insight is associated with specific areas and appears to rely more on retrieving and integrating self-related information.

在过去的几年中，对与精神病的临床和认知洞察力有关的脑部异常引起了浓厚的兴趣，这为文献研究提供了许多神经影像学研究。在当前的研究中，通过进行系统的回顾和荟萃分析，将精神病临床和认知洞察的神经基质的已发表发现进行整合。

使用基于参数坐标的荟萃分析方法进行基于坐标的荟萃分析，使用R中的metafor软件包进行基于非坐标的荟萃分析。系统地回顾了不能纳入荟萃分析的论文。

共检索到37项研究，其中21项研究被纳入荟萃分析。较差的临床见识与较小的全脑灰质和白质量以及额回的灰质量有关。认知见解主要与海马和腹侧前额叶皮层的结构和功能成正相关。

临床洞察力受损与孤立的大脑区域异常无关，但与空间弥散的整体和额叶异常有关，这表明其可能依赖于一系列认知和自我评估过程。认知洞察力与特定领域相关，并且似乎更多地依赖于检索和整合自我相关信息。