Using neuroimaging studies, this research establishes a unique brain pattern that characterizes schizophrenia, distinguishing it from other conditions, and reinforces the idea that the disorder can be understood as a dysfunction in a specific brain network, rather than isolated changes in individual brain regions. These new results propose a single, stable, and unified schizophrenia network, addressing a significant portion of the heterogeneity observed in previous studies of atrophy.
Schizophrenia is a complex psychiatric disorder, and understanding the brain changes associated with it has been challenging due to inconsistent findings in neuroimaging studies.
Schizophrenia can cause changes in the brain. Previous studies confirm the presence of cortical atrophy in patients with schizophrenia, especially in those taking typical antipsychotic medications, and the presence of white matter collapse. The cortical loss associated with schizophrenia is progressive. They also suggest that the physiological effects of aging on brain anatomy may be abnormally pronounced in schizophrenia.
To address this question, researchers at Harvard Medical School conducted a groundbreaking study to identify specific patterns of brain atrophy in schizophrenia.
The work used advanced analytical methods to explore how different brain regions may be connected in a network characteristic of this disorder.
The study used a technique called coordinate network mapping meta-analysis, a methodology that analyzes results from multiple previous studies to identify consistent patterns.
The basis for this analysis was the human connectome, which acts as a “wiring diagram” of the brain, mapping how different regions are interconnected by neural connections.
By integrating data from 90 published studies involving more than 8,000 individuals with schizophrenia, the researchers were able to outline a unique pattern of brain connectivity associated with the disorder, called the schizophrenia network.
The identified network had striking characteristics. It was:
Specific to schizophrenia: The patterns of brain atrophy observed in this network were distinct from those found in other conditions (including individuals at high risk for psychosis, people experiencing normal aging, patients with neurodegenerative disorders such as Alzheimer’s, and other psychiatric disorders such as depression and bipolar disorder).
Stable over time: The patterns of this network remained consistent regardless of the progression of schizophrenia or the presence of different symptom clusters associated with the disease.
Correlated with cognitive functions: The network was compared with brain lesions associated with psychosis-related thought processes in an independent group of 181 individuals. The researchers found a negative correlation, suggesting that the areas affected by atrophy are directly related to impaired cognitive functions in schizophrenia.
This study advances the understanding of the neuroanatomy of schizophrenia by proposing a unified, specific and stable brain network that connects the isolated and heterogeneous findings of previous studies.
The identification of this network not only helps to explain some of the variability observed in the research, but also provides a framework for future studies, paving the way for more precise diagnostic and treatment strategies.
In summary, the research establishes a unique brain pattern that characterizes schizophrenia, distinguishing it from other conditions, and reinforces the idea that the disorder can be understood as a dysfunction in a specific brain network, rather than isolated alterations in individual brain regions.
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Heterogeneous patterns of brain atrophy in schizophrenia localize to a common brain network
Ahmed T. Makhlouf, William Drew, Jacob L. Stubbs, Joseph J. Taylor, Donato Liloia, Jordan Grafman, David Silbersweig, Michael D. Fox & Shan H. Siddiqi
Nature Mental Health (2024)
Abstract:
Understanding the neuroanatomy of schizophrenia remains elusive due to heterogeneous findings across neuroimaging studies. Here we investigated whether patterns of brain atrophy associated with schizophrenia would localize to a common brain network using a coordinate network mapping meta-analysis approach. Utilizing the human connectome as a wiring diagram, we identified a connectivity pattern, a schizophrenia network, uniting heterogeneous results from 90 published studies of atrophy in schizophrenia (total n > 8,000). This network was specific to schizophrenia, differentiating it from atrophy in individuals at high risk for psychosis (n = 3,038), normal aging (n = 4,195), neurodegenerative disorders (n = 3,707) and other psychiatric conditions (n = 3,432). The network was also stable with disease progression and across different clusters of schizophrenia symptoms. Patterns of brain atrophy in schizophrenia were negatively correlated with lesions linked to psychosis-related thought processes in an independent cohort (n = 181). Our results propose a unique, stable, and unified schizophrenia network, addressing a significant portion of the heterogeneity observed in previous atrophy studies.
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