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Berthet P, Haatveit BC, Kjelkenes R, Worker A, Kia SM, Wolfers T, Rutherford S, Alnaes D, Dinga R, Pedersen ML, Dahl A, Fernandez-Cabello S, Dazzan P, Agartz I, Nesvåg R, Ueland T, Andreassen OA, Simonsen C, Westlye LT, Melle I, Marquand A. A 10-Year Longitudinal Study of Brain Cortical Thickness in People with First-Episode Psychosis Using Normative Models. Schizophr Bull 2024:sbae107. [PMID: 38970378 DOI: 10.1093/schbul/sbae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2024]
Abstract
BACKGROUND Clinical forecasting models have potential to optimize treatment and improve outcomes in psychosis, but predicting long-term outcomes is challenging and long-term follow-up data are scarce. In this 10-year longitudinal study, we aimed to characterize the temporal evolution of cortical correlates of psychosis and their associations with symptoms. DESIGN Structural magnetic resonance imaging (MRI) from people with first-episode psychosis and controls (n = 79 and 218) were obtained at enrollment, after 12 months (n = 67 and 197), and 10 years (n = 23 and 77), within the Thematically Organized Psychosis (TOP) study. Normative models for cortical thickness estimated on public MRI datasets (n = 42 983) were applied to TOP data to obtain deviation scores for each region and timepoint. Positive and Negative Syndrome Scale (PANSS) scores were acquired at each timepoint along with registry data. Linear mixed effects models assessed effects of diagnosis, time, and their interactions on cortical deviations plus associations with symptoms. RESULTS LMEs revealed conditional main effects of diagnosis and time × diagnosis interactions in a distributed cortical network, where negative deviations in patients attenuate over time. In patients, symptoms also attenuate over time. LMEs revealed effects of anterior cingulate on PANSS total, and insular and orbitofrontal regions on PANSS negative scores. CONCLUSIONS This long-term longitudinal study revealed a distributed pattern of cortical differences which attenuated over time together with a reduction in symptoms. These findings are not in line with a simple neurodegenerative account of schizophrenia, and deviations from normative models offer a promising avenue to develop biomarkers to track clinical trajectories over time.
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Affiliation(s)
- Pierre Berthet
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Beathe C Haatveit
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Rikka Kjelkenes
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Amanda Worker
- Department of Psychosis Studies, Institute of Psychiatry, King's College, London, UK
| | - Seyed Mostafa Kia
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Psychiatry, Utrecht University Medical Center, Utrecht, the Netherlands
- Department Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - Thomas Wolfers
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Saige Rutherford
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Dag Alnaes
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Richard Dinga
- Department Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - Mads L Pedersen
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Andreas Dahl
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Sara Fernandez-Cabello
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, King's College, London, UK
| | - Ingrid Agartz
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Torill Ueland
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Carmen Simonsen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Andre Marquand
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
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Zhou Z, Jones K, Ivleva EI, Colon-Perez L. Macro- and Micro-Structural Alterations in the Midbrain in Early Psychosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.10.588901. [PMID: 38645197 PMCID: PMC11030414 DOI: 10.1101/2024.04.10.588901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Introduction Early psychosis (EP) is a critical period in the course of psychotic disorders during which the brain is thought to undergo rapid and significant functional and structural changes 1 . Growing evidence suggests that the advent of psychotic disorders is early alterations in the brain's functional connectivity and structure, leading to aberrant neural network organization. The Human Connectome Project (HCP) is a global effort to map the human brain's connectivity in healthy and disease populations; within HCP, there is a specific dataset that focuses on the EP subjects (i.e., those within five years of the initial psychotic episode) (HCP-EP), which is the focus of our study. Given the critically important role of the midbrain function and structure in psychotic disorders (cite), and EP in particular (cite), we specifically focused on the midbrain macro- and micro-structural alterations and their association with clinical outcomes in HCP-EP. Methods We examined macro- and micro-structural brain alterations in the HCP-EP sample (n=179: EP, n=123, Controls, n=56) as well as their associations with behavioral measures (i.e., symptoms severity) using a stepwise approach, incorporating a multimodal MRI analysis procedure. First, Deformation Based Morphometry (DBM) was carried out on the whole brain 3 Tesla T1w images to examine gross brain anatomy (i.e., seed-based and voxel-based volumes). Second, we extracted Fractional Anisotropy (FA), Axial Diffusivity (AD), and Mean Diffusivity (MD) indices from the Diffusion Tensor Imaging (DTI) data; a midbrain mask was created based on FreeSurfer v.6.0 atlas. Third, we employed Tract-Based Spatial Statistics (TBSS) to determine microstructural alterations in white matter tracts within the midbrain and broader regions. Finally, we conducted correlation analyses to examine associations between the DBM-, DTI- and TBSS-based outcomes and the Positive and Negative Syndrome Scale (PANSS) scores. Results DBM analysis showed alterations in the hippocampus, midbrain, and caudate/putamen. A DTI voxel-based analysis shows midbrain reductions in FA and AD and increases in MD; meanwhile, the hippocampus shows an increase in FA and a decrease in AD and MD. Several key brain regions also show alterations in DTI indices (e.g., insula, caudate, prefrontal cortex). A seed-based analysis centered around a midbrain region of interest obtained from freesurfer segmentation confirms the voxel-based analysis of DTI indices. TBSS successfully captured structural differences within the midbrain and complementary alterations in other main white matter tracts, such as the corticospinal tract and cingulum, suggesting early altered brain connectivity in EP. Correlations between these quantities in the EP group and behavioral scores (i.e., PANSS and CAINS tests) were explored. It was found that midbrain volume noticeably correlates with the Cognitive score of PA and all DTI metrics. FA correlates with the several dimensions of the PANSS, while AD and MD do not show many associations with PANSS or CAINS. Conclusions Our findings contribute to understanding the midbrain-focused circuitry involvement in EP and complimentary alteration in EP. Our work provides a path for future investigations to inform specific brain-based biomarkers of EP and their relationships to clinical manifestations of the psychosis course.
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Thalhammer M, Schulz J, Scheulen F, Oubaggi MEM, Kirschner M, Kaiser S, Schmidt A, Borgwardt S, Avram M, Brandl F, Sorg C. Distinct Volume Alterations of Thalamic Nuclei Across the Schizophrenia Spectrum. Schizophr Bull 2024:sbae037. [PMID: 38577901 DOI: 10.1093/schbul/sbae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND HYPOTHESIS Abnormal thalamic nuclei volumes and their link to cognitive impairments have been observed in schizophrenia. However, whether and how this finding extends to the schizophrenia spectrum is unknown. We hypothesized a distinct pattern of aberrant thalamic nuclei volume across the spectrum and examined its potential associations with cognitive symptoms. STUDY DESIGN We performed a FreeSurfer-based volumetry of T1-weighted brain MRIs from 137 healthy controls, 66 at-risk mental state (ARMS) subjects, 89 first-episode psychosis (FEP) individuals, and 126 patients with schizophrenia to estimate thalamic nuclei volumes of six nuclei groups (anterior, lateral, ventral, intralaminar, medial, and pulvinar). We used linear regression models, controlling for sex, age, and estimated total intracranial volume, both to compare thalamic nuclei volumes across groups and to investigate their associations with positive, negative, and cognitive symptoms. STUDY RESULTS We observed significant volume alterations in medial and lateral thalamic nuclei. Medial nuclei displayed consistently reduced volumes across the spectrum compared to controls, while lower lateral nuclei volumes were only observed in schizophrenia. Whereas positive and negative symptoms were not associated with reduced nuclei volumes across all groups, higher cognitive scores were linked to lower volumes of medial nuclei in ARMS. In FEP, cognition was not linked to nuclei volumes. In schizophrenia, lower cognitive performance was associated with lower medial volumes. CONCLUSIONS Results demonstrate distinct thalamic nuclei volume reductions across the schizophrenia spectrum, with lower medial nuclei volumes linked to cognitive deficits in ARMS and schizophrenia. Data suggest a distinctive trajectory of thalamic nuclei abnormalities along the course of schizophrenia.
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Affiliation(s)
- Melissa Thalhammer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Julia Schulz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Felicitas Scheulen
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Mohamed El Mehdi Oubaggi
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Kirschner
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Kaiser
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - André Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Felix Brandl
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christian Sorg
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
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Young T, Kumar VJ, Saranathan M. Normative modeling of thalamic nuclear volumes. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.06.24303871. [PMID: 38496426 PMCID: PMC10942522 DOI: 10.1101/2024.03.06.24303871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Thalamic nuclei have been implicated in neurodegenerative and neuropsychiatric disorders. Normative models for thalamic nuclear volumes have not been proposed thus far. The aim of this work was to establish normative models of thalamic nuclear volumes and subsequently investigate changes in thalamic nuclei in cognitive and psychiatric disorders. Volumes of the bilateral thalami and 12 nuclear regions were generated from T1 MRI data using a novel segmentation method (HIPS-THOMAS) in healthy control subjects (n=2374) and non-control subjects (n=695) with early and late mild cognitive impairment (EMCI, LMCI), Alzheimer's disease (AD), Early psychosis and Schizophrenia, Bipolar disorder, and Attention deficit hyperactivity disorder. Three different normative modelling methods were evaluated while controlling for sex, intracranial volume, and site. Z-scores and extreme z-score deviations were calculated and compared across phenotypes. GAMLSS models performed the best. Statistically significant shifts in z-score distributions consistent with atrophy were observed for most phenotypes. Shifts of progressively increasing magnitude were observed bilaterally from EMCI to AD with larger shifts in the left thalamic regions. Heterogeneous shifts were observed in psychiatric diagnoses with a predilection for the right thalamic regions. Here we present the first normative models of thalamic nuclear volumes and highlight their utility in evaluating heterogenous disorders such as Schizophrenia.
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Affiliation(s)
- Taylor Young
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA
| | | | - Manojkumar Saranathan
- Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA
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Gaiser C, Berthet P, Kia SM, Frens MA, Beckmann CF, Muetzel RL, Marquand AF. Estimating cortical thickness trajectories in children across different scanners using transfer learning from normative models. Hum Brain Mapp 2024; 45:e26565. [PMID: 38339954 PMCID: PMC10839740 DOI: 10.1002/hbm.26565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/28/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024] Open
Abstract
This work illustrates the use of normative models in a longitudinal neuroimaging study of children aged 6-17 years and demonstrates how such models can be used to make meaningful comparisons in longitudinal studies, even when individuals are scanned with different scanners across successive study waves. More specifically, we first estimated a large-scale reference normative model using Hierarchical Bayesian Regression from N = 42,993 individuals across the lifespan and from dozens of sites. We then transfer these models to a longitudinal developmental cohort (N = 6285) with three measurement waves acquired on two different scanners that were unseen during estimation of the reference models. We show that the use of normative models provides individual deviation scores that are independent of scanner effects and efficiently accommodate inter-site variations. Moreover, we provide empirical evidence to guide the optimization of sample size for the transfer of prior knowledge about the distribution of regional cortical thicknesses. We show that a transfer set containing as few as 25 samples per site can lead to good performance metrics on the test set. Finally, we demonstrate the clinical utility of this approach by showing that deviation scores obtained from the transferred normative models are able to detect and chart morphological heterogeneity in individuals born preterm.
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Affiliation(s)
- C. Gaiser
- Department of Neuroscience, Erasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands
- The Generation R Study Group, Erasmus MC—Sophia Children's HospitalUniversity Medical Centre RotterdamRotterdamThe Netherlands
| | - P. Berthet
- Department of PsychologyUniversity of OsloOsloNorway
- Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo, and Oslo University HospitalOsloNorway
| | - S. M. Kia
- Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
- Department of PsychiatryUtrecht University Medical CenterUtrechtThe Netherlands
- Department of Cognitive Science and Artificial IntelligenceTilburg UniversityTilburgThe Netherlands
| | - M. A. Frens
- Department of Neuroscience, Erasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands
| | - C. F. Beckmann
- Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
- Department of Cognitive NeuroscienceRadboud University Medical CenterNijmegenThe Netherlands
- Centre for Functional MRI of the BrainUniversity of OxfordOxfordUK
| | - R. L. Muetzel
- Department of Child and Adolescent Psychiatry, Erasmus MC—Sophia Children's HospitalUniversity Medical Centre RotterdamRotterdamThe Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC—Sophia Children's HospitalUniversity Medical Centre RotterdamRotterdamThe Netherlands
| | - Andre F. Marquand
- Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
- Department of Cognitive NeuroscienceRadboud University Medical CenterNijmegenThe Netherlands
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Joo SW, Jo YT, Kim Y, Lee WH, Chung YC, Lee J. Structural variability of the cerebral cortex in schizophrenia and its association with clinical symptoms. Psychol Med 2024; 54:399-408. [PMID: 37485703 DOI: 10.1017/s0033291723001988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND Substantial evidence indicates structural abnormalities in the cerebral cortex of patients with schizophrenia (SCZ), although their clinical implications remain unclear. Previous case-control studies have investigated group-level differences in structural abnormalities, although the study design cannot account for interindividual differences. Recent research has focused on the association between the heterogeneity of the cerebral cortex morphometric features and clinical heterogeneity. METHODS We used neuroimaging data from 420 healthy controls and 695 patients with SCZ from seven studies. Four cerebral cortex measures were obtained: surface area, gray matter volume, thickness, and local gyrification index. We calculated the coefficient of variation (CV) and person-based similarity index (PBSI) scores and performed group comparisons. Associations between the PBSI scores and cognitive functions were evaluated using Spearman's rho test and normative modeling. RESULTS Patients with SCZ had a greater CV of surface area and cortical thickness than those of healthy controls. All PBSI scores across cortical measures were lower in patients with SCZ than in HCs. In the patient group, the PBSI scores for gray matter volume and all cortical measures taken together positively correlated with the full-scale IQ scores. Patients with deviant PBSI scores for gray matter volume and all cortical measures taken together had lower full-scale IQ scores than those of other patients. CONCLUSIONS The cerebral cortex in patients with SCZ showed greater regional and global structural variability than that in healthy controls. Patients with deviant similarity of cortical structural profiles exhibited a lower general intelligence than those exhibited by the other patients.
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Affiliation(s)
- Sung Woo Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Tak Jo
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Yangsik Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Won Hee Lee
- Department of Software Convergence, Kyung Hee University, Yongin, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jungsun Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Worker A, Berthert P, Lawrence AJ, Kia SM, Arango C, Dinga R, Galderisi S, Glenthøj B, Kahn RS, Leslie A, Murray RM, Pariante CM, Pantelis C, Weiser M, Winter-van Rossum I, McGuire P, Dazzan P, Marquand AF. Extreme deviations from the normative model reveal cortical heterogeneity and associations with negative symptom severity in first-episode psychosis from the OPTiMiSE and GAP studies. Transl Psychiatry 2023; 13:373. [PMID: 38042835 PMCID: PMC10693627 DOI: 10.1038/s41398-023-02661-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/04/2023] Open
Abstract
There is currently no quantifiable method to predict long-term clinical outcomes in patients presenting with a first episode of psychosis. A major barrier to developing useful markers for this is biological heterogeneity, where many different pathological mechanisms may underly the same set of symptoms in different individuals. Normative modelling has been used to quantify this heterogeneity in established psychotic disorders by identifying regions of the cortex which are thinner than expected based on a normative healthy population range. These brain atypicalities are measured at the individual level and therefore potentially useful in a clinical setting. However, it is still unclear whether alterations in individual brain structure can be detected at the time of the first psychotic episode, and whether they are associated with subsequent clinical outcomes. We applied normative modelling of cortical thickness to a sample of first-episode psychosis patients, with the aim of quantifying heterogeneity and to use any pattern of cortical atypicality to predict symptoms and response to antipsychotic medication at timepoints from baseline up to 95 weeks (median follow-ups = 4). T1-weighted brain magnetic resonance images from the GAP and OPTiMiSE samples were processed with Freesurfer V6.0.0 yielding 148 cortical thickness features. An existing normative model of cortical thickness (n = 37,126) was adapted to integrate data from each clinical site and account for effects of gender and site. Our test sample consisted of control participants (n = 149, mean age = 26, SD = 6.7) and patient data (n = 295, mean age = 26, SD = 6.7), this sample was used for estimating deviations from the normative model and subsequent statistical analysis. For each individual, the 148 cortical thickness features were mapped to centiles of the normative distribution and converted to z-scores reflecting the distance from the population mean. Individual cortical thickness metrics of +/- 2.6 standard deviations from the mean were considered extreme deviations from the norm. We found that no more than 6.4% of psychosis patients had extreme deviations in a single brain region (regional overlap) demonstrating a high degree of heterogeneity. Mann-Whitney U tests were run on z-scores for each region and significantly lower z-scores were observed in FEP patients in the frontal, temporal, parietal and occipital lobes. Finally, linear mixed-effects modelling showed that negative deviations in cortical thickness in parietal and temporal regions at baseline are related to more severe negative symptoms over the medium-term. This study shows that even at the early stage of symptom onset normative modelling provides a framework to identify individualised cortical markers which can be used for early personalised intervention and stratification.
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Affiliation(s)
- Amanda Worker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pierre Berthert
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Seyed Mostafa Kia
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, the Netherlands
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense Madrid, Madrid, Spain
| | - Richard Dinga
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Birte Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center, Glostrup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anoushka Leslie
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carmine M Pariante
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust and King's College London, London, UK
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Tel Aviv, 52621, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inge Winter-van Rossum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust and King's College London, London, UK
| | - Andre F Marquand
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, the Netherlands.
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands.
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Omlor W, Rabe F, Fuchs S, Cecere G, Homan S, Surbeck W, Kallen N, Georgiadis F, Spiller T, Seifritz E, Weickert T, Bruggemann J, Weickert C, Potkin S, Hashimoto R, Sim K, Rootes-Murdy K, Quide Y, Houenou J, Banaj N, Vecchio D, Piras F, Piras F, Spalletta G, Salvador R, Karuk A, Pomarol-Clotet E, Rodrigue A, Pearlson G, Glahn D, Tomecek D, Spaniel F, Skoch A, Kirschner M, Kaiser S, Kochunov P, Fan FM, Andreassen OA, Westlye LT, Berthet P, Calhoun VD, Howells F, Uhlmann A, Scheffler F, Stein D, Iasevoli F, Cairns MJ, Carr VJ, Catts SV, Di Biase MA, Jablensky A, Green MJ, Henskens FA, Klauser P, Loughland C, Michie PT, Mowry B, Pantelis C, Rasser PE, Schall U, Scott R, Zalesky A, de Bartolomeis A, Barone A, Ciccarelli M, Brunetti A, Cocozza S, Pontillo G, Tranfa M, Di Giorgio A, Thomopoulos SI, Jahanshad N, Thompson PM, van Erp T, Turner J, Homan P. Estimating multimodal brain variability in schizophrenia spectrum disorders: A worldwide ENIGMA study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.22.559032. [PMID: 37961617 PMCID: PMC10634976 DOI: 10.1101/2023.09.22.559032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Objective Schizophrenia is a multifaceted disorder associated with structural brain heterogeneity. Despite its relevance for identifying illness subtypes and informative biomarkers, structural brain heterogeneity in schizophrenia remains incompletely understood. Therefore, the objective of this study was to provide a comprehensive insight into the structural brain heterogeneity associated with schizophrenia. Methods This meta- and mega-analysis investigated the variability of multimodal structural brain measures of white and gray matter in individuals with schizophrenia versus healthy controls. Using the ENIGMA dataset of MRI-based brain measures from 22 international sites with up to 6139 individuals for a given brain measure, we examined variability in cortical thickness, surface area, folding index, subcortical volume and fractional anisotropy. Results We found that individuals with schizophrenia are distinguished by higher heterogeneity in the frontotemporal network with regard to multimodal structural measures. Moreover, individuals with schizophrenia showed higher homogeneity of the folding index, especially in the left parahippocampal region. Conclusions Higher multimodal heterogeneity in frontotemporal regions potentially implies different subtypes of schizophrenia that converge on impaired frontotemporal interaction as a core feature of the disorder. Conversely, more homogeneous folding patterns in the left parahippocampal region might signify a consistent characteristic of schizophrenia shared across subtypes. These findings underscore the importance of structural brain variability in advancing our neurobiological understanding of schizophrenia, and aid in identifying illness subtypes as well as informative biomarkers.
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Xu Y, Guo H, Zheng R, Wei Y, Wen B, Fang K, Zhang Y, Cheng J, Han S. Decreased intrinsic neural timescales in obsessive compulsive disorder and two distinct subtypes revealed by heterogeneity through discriminative analysis. J Affect Disord 2023; 340:667-674. [PMID: 37543114 DOI: 10.1016/j.jad.2023.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND OCD is featured as the destruction of information storage and processing. The cognition of neurobiological and clinical heterogeneity is in suspense and poorly studied. METHODS Ninety-nine patients and matched HCs(n = 104) were recruited and underwent resting-state functional MRI scans. We applied INT to evaluate altered local neural dynamics representing the ability of information integration. Moreover, considering OCD was a highly heterogeneous disorder, we investigated putative OCD subtypes from INT using a novel semi-supervised machine learning, named HYDRA. RESULTS Compared with HCs, patients with OCD showed decreased INTs in extensive brain regions, including bilateral cerebellum and precuneus, STG/MTG and PCC, hippocampus in DMN; right IFG/MFG/SFG, SPL and bilateral angular gyrus in CEN and insula, SMA in SN. Moreover, many other regions involved in visual processing also had disrupted dynamics of local neural organization, consisting of bilateral CUN, LING and fusiform gyrus and occipital lobe. HYDRA divided patients into two distinct neuroanatomical subtypes from INT. Subtype 1 showed decreased INTs in distributed networks, while subtype 2 presented increased in several common regions which were also found to be decreased in subtype 1, such as STG, IPL, postcentral gyrus and left insula, supramarginal gyrus. CONCLUSION This study showed distinct abnormalities from the perspective of dynamics of local neural organization in OCD. Such alteration and dimensional approach may provide a new insight into the prior traditional cognition of this disorder and to some extent do favor of more precise diagnosis and treatment response in the future.
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Affiliation(s)
- Yinhuan Xu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huirong Guo
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruiping Zheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Baohong Wen
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Keke Fang
- Clinical Research Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Shaoqiang Han
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Xie Y, Sun J, Man W, Zhang Z, Zhang N. Personalized estimates of brain cortical structural variability in individuals with Autism spectrum disorder: the predictor of brain age and neurobiology relevance. Mol Autism 2023; 14:27. [PMID: 37507798 PMCID: PMC10375633 DOI: 10.1186/s13229-023-00558-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a heritable condition related to brain development that affects a person's perception and socialization with others. Here, we examined variability in the brain morphology in ASD children and adolescent individuals at the level of brain cortical structural profiles and the level of each brain regional measure. METHODS We selected brain structural MRI data in 600 ASDs and 729 normal controls (NCs) from Autism Brain Imaging Data Exchange (ABIDE). The personalized estimate of similarity between gray matter volume (GMV) profiles of an individual to that of others in the same group was assessed by using the person-based similarity index (PBSI). Regional contributions to PBSI score were utilized for brain age gap estimation (BrainAGE) prediction model establishment, including support vector regression (SVR), relevance vector regression (RVR), and Gaussian process regression (GPR). The association between BrainAGE prediction in ASD and clinical performance was investigated. We further explored the related inter-regional profiles of gene expression from the Allen Human Brain Atlas with variability differences in the brain morphology between groups. RESULTS The PBSI score of GMV was negatively related to age regardless of the sample group, and the PBSI score was significantly lower in ASDs than in NCs. The regional contributions to the PBSI score of 126 brain regions in ASDs showed significant differences compared to NCs. RVR model achieved the best performance for predicting brain age. Higher inter-individual brain morphology variability was related to increased brain age, specific to communication symptoms. A total of 430 genes belonging to various pathways were identified as associated with brain cortical morphometric variation. The pathways, including short-term memory, regulation of system process, and regulation of nervous system process, were dominated mainly by gene sets for manno midbrain neurotypes. LIMITATIONS There is a sample mismatch between the gene expression data and brain imaging data from ABIDE. A larger sample size can contribute to the model training of BrainAGE and the validation of the results. CONCLUSIONS ASD has personalized heterogeneity brain morphology. The brain age gap estimation and transcription-neuroimaging associations derived from this trait are replenished in an additional direction to boost the understanding of the ASD brain.
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Affiliation(s)
- Yingying Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Jie Sun
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Weiqi Man
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Zhang Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
| | - Ningnannan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
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Sun J, Zhao W, Xie Y, Zhou F, Wu L, Li Y, Li H, Li Y, Zeng C, Han X, Liu Y, Zhang N. Personalized estimates of morphometric similarity in multiple sclerosis and neuromyelitis optica spectrum disorders. Neuroimage Clin 2023; 39:103454. [PMID: 37343344 PMCID: PMC10509529 DOI: 10.1016/j.nicl.2023.103454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/21/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
Brain morphometric alterations involve multiple brain regions on progression of the disease in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) and exhibit age-related degenerative changes during the pathological aging. Recent advance in brain morphometry as measured using MRI have leveraged Person-Based Similarity Index (PBSI) approach to assess the extent of within-diagnosis similarity or heterogeneity of brain neuroanatomical profiles between individuals of healthy populations and validate in neuropsychiatric disorders. Brain morphometric changes throughout the lifespan would be invaluable for understanding regional variability of age-related structural degeneration and the substrate of inflammatory demyelinating disease. Here, we aimed to quantify the neuroanatomical profiles with PBSI measures of cortical thickness (CT) and subcortical volumes (SV) in 263 MS, 207 NMOSD, and 338 healthy controls (HC) from six separate central datasets (aged 11-80). We explored the between-group comparisons of PBSI measures, as well as the advancing age and sex effects on PBSI measures. Compared to NMOSD, MS showed a lower extent of within-diagnosis similarity. Significant differences in regional contributions to PBSI score were observed in 29 brain regions between MS and NMOSD (P < 0.05/164, Bonferroni corrected), of which bilateral cerebellum in MS and bilateral parahippocampal gyrus in NMOSD represented the highest divergence between the two patient groups, with a high similarity effect within each group. The PBSI scores were generally lower with advancing age, but their associations showed different patterns depending on the age range. For MS, CT profiles were significantly negatively correlated with age until the early 30 s (ρ = -0.265, P = 0.030), while for NMOSD, SV profiles were significantly negatively correlated with age with 51 year-old and older (ρ = -0.365, P = 0.008). The current study suggests that PBSI approach could be used to quantify the variation in brain morphometric changes in CNS inflammatory demyelinating disease, and exhibited a greater neuroanatomical heterogeneity pattern in MS compared with NMOSD. Our results reveal that, as an MR marker, PBSI may be sensitive to distribute the disease-associated grey matter diversity and complexity. Disease-driven production of regionally selective and age stage-dependency changes in the neuroanatomical profile of MS and NMOSD should be considered to facilitate the prediction of clinical outcomes and assessment of treatment responses.
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Affiliation(s)
- Jie Sun
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wenjin Zhao
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yingying Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Fuqing Zhou
- Department of Radiology, The First Afliated Hospital, Nanchang University, Nanchang 330006, Jiangxi Province, China
- Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang 330006, Jiangxi Province, China
| | - Lin Wu
- Department of Radiology, The First Afliated Hospital, Nanchang University, Nanchang 330006, Jiangxi Province, China
- Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang 330006, Jiangxi Province, China
| | - Yuxin Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Haiqing Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yongmei Li
- Department of Radiology, The First Afliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Chun Zeng
- Department of Radiology, The First Afliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xuemei Han
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun 130031, Jilin Province, China
| | - Yaou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119, The West Southern 4th Ring Road, Fengtai District, Beijing 100070, China
| | - Ningnannan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
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Han S, Xue K, Chen Y, Xu Y, Li S, Song X, Guo HR, Fang K, Zheng R, Zhou B, Chen J, Wei Y, Zhang Y, Cheng J. Identification of shared and distinct patterns of brain network abnormality across mental disorders through individualized structural covariance network analysis. Psychol Med 2023; 53:1-12. [PMID: 36876493 DOI: 10.1017/s0033291723000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Mental disorders, including depression, obsessive compulsive disorder (OCD), and schizophrenia, share a common neuropathy of disturbed large-scale coordinated brain maturation. However, high-interindividual heterogeneity hinders the identification of shared and distinct patterns of brain network abnormalities across mental disorders. This study aimed to identify shared and distinct patterns of altered structural covariance across mental disorders. METHODS Subject-level structural covariance aberrance in patients with mental disorders was investigated using individualized differential structural covariance network. This method inferred structural covariance aberrance at the individual level by measuring the degree of structural covariance in patients deviating from matched healthy controls (HCs). T1-weighted anatomical images of 513 participants (105, 98, 190 participants with depression, OCD and schizophrenia, respectively, and 130 age- and sex-matched HCs) were acquired and analyzed. RESULTS Patients with mental disorders exhibited notable heterogeneity in terms of altered edges, which were otherwise obscured by group-level analysis. The three disorders shared high difference variability in edges attached to the frontal network and the subcortical-cerebellum network, and they also exhibited disease-specific variability distributions. Despite notable variability, patients with the same disorder shared disease-specific groups of altered edges. Specifically, depression was characterized by altered edges attached to the subcortical-cerebellum network; OCD, by altered edges linking the subcortical-cerebellum and motor networks; and schizophrenia, by altered edges related to the frontal network. CONCLUSIONS These results have potential implications for understanding heterogeneity and facilitating personalized diagnosis and interventions for mental disorders.
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Affiliation(s)
- Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Kangkang Xue
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yinhuan Xu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui-Rong Guo
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Keke Fang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Bingqian Zhou
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Jingli Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
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Korda AI, Andreou C, Avram M, Handels H, Martinetz T, Borgwardt S. Chaos analysis of the brain topology in first-episode psychosis and clinical high risk patients. Front Psychiatry 2022; 13:965128. [PMID: 36311536 PMCID: PMC9606602 DOI: 10.3389/fpsyt.2022.965128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Structural MRI studies in first-episode psychosis (FEP) and in clinical high risk (CHR) patients have consistently shown volumetric abnormalities in frontal, temporal, and cingulate cortex areas. The aim of the present study was to employ chaos analysis for the identification of brain topology differences in people with psychosis. Structural MRI were acquired from 77 FEP, 73 CHR and 44 healthy controls (HC). Chaos analysis of the gray matter distribution was performed: First, the distances of each voxel from the center of mass in the gray matter image was calculated. Next, the distances multiplied by the voxel intensity were represented as a spatial-series, which then was analyzed by extracting the Largest-Lyapunov-Exponent (lambda). The lambda brain map depicts thus how the gray matter topology changes. Between-group differences were identified by (a) comparing the lambda brain maps, which resulted in statistically significant differences in FEP and CHR compared to HC; and (b) matching the lambda series with the Morlet wavelet, which resulted in statistically significant differences in the scalograms of FEP against CHR and HC. The proposed framework using spatial-series extraction enhances the between-group differences of FEP, CHR and HC subjects, verifies diagnosis-relevant features and may potentially contribute to the identification of structural biomarkers for psychosis.
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Affiliation(s)
- Alexandra I. Korda
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
| | - Christina Andreou
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
| | - Heinz Handels
- Institute of Medical Informatics, University of Lübeck, Lübeck, Germany
| | - Thomas Martinetz
- Institute for Neuro- and Bioinformatics, University of Lübeck, Lübeck, Germany
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
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Thng G, Shen X, Stolicyn A, Harris MA, Adams MJ, Barbu MC, Kwong ASF, Frangou S, Lawrie SM, McIntosh AM, Romaniuk L, Whalley HC. Comparing personalized brain-based and genetic risk scores for major depressive disorder in large population samples of adults and adolescents. Eur Psychiatry 2022; 65:e44. [PMID: 35899848 PMCID: PMC9393914 DOI: 10.1192/j.eurpsy.2022.2301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a polygenic disorder associated with brain alterations but until recently, there have been no brain-based metrics to quantify individual-level variation in brain morphology. Here, we evaluated and compared the performance of a new brain-based 'Regional Vulnerability Index' (RVI) with polygenic risk scores (PRS), in the context of MDD. We assessed associations with syndromal MDD in an adult sample (N = 702, age = 59 ± 10) and with subclinical depressive symptoms in a longitudinal adolescent sample (baseline N = 3,825, age = 10 ± 1; 2-year follow-up N = 2,081, age = 12 ± 1). METHODS MDD-RVIs quantify the correlation of the individual's corresponding brain metric with the expected pattern for MDD derived in an independent sample. Using the same methodology across samples, subject-specific MDD-PRS and six MDD-RVIs based on different brain modalities (subcortical volume, cortical thickness, cortical surface area, mean diffusivity, fractional anisotropy, and multimodal) were computed. RESULTS In adults, MDD-RVIs (based on white matter and multimodal measures) were more strongly associated with MDD (β = 0.099-0.281, PFDR = 0.001-0.043) than MDD-PRS (β = 0.056-0.152, PFDR = 0.140-0.140). In adolescents, depressive symptoms were associated with MDD-PRS at baseline and follow-up (β = 0.084-0.086, p = 1.38 × 10-4-4.77 × 10-4) but not with any MDD-RVIs (β < 0.05, p > 0.05). CONCLUSIONS Our results potentially indicate the ability of brain-based risk scores to capture a broader range of risk exposures than genetic risk scores in adults and are also useful in helping us to understand the temporal origins of depression-related brain features. Longitudinal data, specific to the developmental period and on white matter measures, will be useful in informing risk for subsequent psychiatric illness.
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Affiliation(s)
- Gladi Thng
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Aleks Stolicyn
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Mathew A. Harris
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Mark J. Adams
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Miruna C. Barbu
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Alex S. F. Kwong
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sophia Frangou
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stephen M. Lawrie
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Andrew M. McIntosh
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Liana Romaniuk
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
| | - Heather C. Whalley
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, United Kingdom
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15
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Neuroanatomical heterogeneity and homogeneity in individuals at clinical high risk for psychosis. Transl Psychiatry 2022; 12:297. [PMID: 35882855 PMCID: PMC9325730 DOI: 10.1038/s41398-022-02057-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 12/12/2022] Open
Abstract
Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P consortium applied a harmonised analysis to neuroimaging data across 29 international sites, including 1579 CHR-P individuals and 1243 HC, offering the largest pooled CHR-P neuroimaging dataset to date. Regional heterogeneity was indexed with the Variability Ratio (VR) and Coefficient of Variation (CV) ratio applied at the group level. Personalised estimates of heterogeneity of SA, CT and SV brain profiles were indexed with the novel Person-Based Similarity Index (PBSI), with two complementary applications. First, to assess the extent of within-diagnosis similarity or divergence of neuroanatomical profiles between individuals. Second, using a normative modelling approach, to assess the 'normativeness' of neuroanatomical profiles in individuals at CHR-P. CHR-P individuals demonstrated no greater regional heterogeneity after applying FDR corrections. However, PBSI scores indicated significantly greater neuroanatomical divergence in global SA, CT and SV profiles in CHR-P individuals compared with HC. Normative PBSI analysis identified 11 CHR-P individuals (0.70%) with marked deviation (>1.5 SD) in SA, 118 (7.47%) in CT and 161 (10.20%) in SV. Psychosis transition was not significantly associated with any measure of heterogeneity. Overall, our examination of neuroanatomical heterogeneity within the CHR-P state indicated greater divergence in neuroanatomical profiles at an individual level, irrespective of psychosis conversion. Further large-scale investigations are required of those who demonstrate marked deviation.
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16
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Fang K, Wen B, Niu L, Wan B, Zhang W. Higher brain structural heterogeneity in schizophrenia. Front Psychiatry 2022; 13:1017399. [PMID: 36213909 PMCID: PMC9537350 DOI: 10.3389/fpsyt.2022.1017399] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
As a highly heterogeneous disorder, schizophrenia shows notable interindividual variation in clinical manifestations. On that account, an increasing number of studies begin to examine the interindividual variability in neuroimaging characterization in schizophrenia. However, whether schizophrenia demonstrates higher interindividual morphological variability than health controls (HCs) remains unknown. T1-weighted anatomical images were obtained from patients with schizophrenia (n = 61) and matched HCs (n = 73). For each subject, voxel-wise gray matter volume was obtained using voxel-based morphometry analysis. We first inquired whether patients with schizophrenia showed higher interindividual structural variation than HCs using the person based similarity index (PBSI). Then, we examined differences of voxel-wise morphological coefficient of variation (CV) between schizophrenia and HCs. To further associate identified regions showing higher variability in schizophrenia with cognitive/functional processes, functional annotation was performed. Patients with schizophrenia exhibited lower PBSIs than matched HCs, suggesting higher interindividual morphological variability in schizophrenia. The following results showed that patients with schizophrenia exhibited higher CVs than HCs in distributed brain regions including the striatum, hippocampus, thalamus, parahippocampa gyrus, frontal gyrus, and amygdala. Brain regions showing higher CVs in schizophrenia were significantly implicated in affective, incentive and reward related terms. These results provide a new insight into the high clinical heterogeneity and facilitate personalized diagnose and treatment in schizophrenia.
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Affiliation(s)
- Keke Fang
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.,Henan Engineering Research Center for Tumor Precision Medicine and Comprehensive Evaluation, Henan Cancer Hospital, Zhengzhou, China.,Henan Provincial Key Laboratory of Anticancer Drug Research, Henan Cancer Hospital, Zhengzhou, China
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lianjie Niu
- Department of Breast Disease, Henan Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Bo Wan
- Nanyang Institute of Technology, Nanyang, China
| | - Wenzhou Zhang
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.,Henan Engineering Research Center for Tumor Precision Medicine and Comprehensive Evaluation, Henan Cancer Hospital, Zhengzhou, China.,Henan Provincial Key Laboratory of Anticancer Drug Research, Henan Cancer Hospital, Zhengzhou, China
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17
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Resolving heterogeneity in schizophrenia through a novel systems approach to brain structure: individualized structural covariance network analysis. Mol Psychiatry 2021; 26:7719-7731. [PMID: 34316005 DOI: 10.1038/s41380-021-01229-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/15/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022]
Abstract
Reliable mapping of system-level individual differences is a critical first step toward precision medicine for complex disorders such as schizophrenia. Disrupted structural covariance indicates a system-level brain maturational disruption in schizophrenia. However, most studies examine structural covariance at the group level. This prevents subject-level inferences. Here, we introduce a Network Template Perturbation approach to construct individual differential structural covariance network (IDSCN) using regional gray-matter volume. IDSCN quantifies how structural covariance between two nodes in a patient deviates from the normative covariance in healthy subjects. We analyzed T1 images from 1287 subjects, including 107 first-episode (drug-naive) patients and 71 controls in the discovery datasets and established robustness in 213 first-episode (drug-naive), 294 chronic, 99 clinical high-risk patients, and 494 controls from the replication datasets. Patients with schizophrenia were highly variable in their altered structural covariance edges; the number of altered edges was related to severity of hallucinations. Despite this variability, a subset of covariance edges, including the left hippocampus-bilateral putamen/globus pallidus edges, clustered patients into two distinct subgroups with opposing changes in covariance compared to controls, and significant differences in their anxiety and depression scores. These subgroup differences were stable across all seven datasets with meaningful genetic associations and functional annotation for the affected edges. We conclude that the underlying physiology of affective symptoms in schizophrenia involves the hippocampus and putamen/pallidum, predates disease onset, and is sufficiently consistent to resolve morphological heterogeneity throughout the illness course. The two schizophrenia subgroups identified thus have implications for the nosology and clinical treatment.
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