Scientific article
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English

Connectome architecture shapes large-scale cortical alterations in schizophrenia : a worldwide ENIGMA study

Published inMolecular psychiatry, vol. 29, no. 6, p. 1869-1881
Publication date2024-06
First online date2024-02-09
Abstract

Schizophrenia is a prototypical network disorder with widespread brain-morphological alterations, yet it remains unclear whether these distributed alterations robustly reflect the underlying network layout. We tested whether large-scale structural alterations in schizophrenia relate to normative structural and functional connectome architecture, and systematically evaluated robustness and generalizability of these network-level alterations. Leveraging anatomical MRI scans from 2439 adults with schizophrenia and 2867 healthy controls from 26 ENIGMA sites and normative data from the Human Connectome Project (n = 207), we evaluated structural alterations of schizophrenia against two network susceptibility models: (i) hub vulnerability, which examines associations between regional network centrality and magnitude of disease-related alterations; (ii) epicenter mapping, which identifies regions whose typical connectivity profile most closely resembles the disease-related morphological alterations. To assess generalizability and specificity, we contextualized the influence of site, disease stages, and individual clinical factors and compared network associations of schizophrenia with that found in affective disorders. Our findings show schizophrenia-related cortical thinning is spatially associated with functional and structural hubs, suggesting that highly interconnected regions are more vulnerable to morphological alterations. Predominantly temporo-paralimbic and frontal regions emerged as epicenters with connectivity profiles linked to schizophrenia's alteration patterns. Findings were robust across sites, disease stages, and related to individual symptoms. Moreover, transdiagnostic comparisons revealed overlapping epicenters in schizophrenia and bipolar, but not major depressive disorder, suggestive of a pathophysiological continuity within the schizophrenia-bipolar-spectrum. In sum, cortical alterations over the course of schizophrenia robustly follow brain network architecture, emphasizing marked hub susceptibility and temporo-frontal epicenters at both the level of the group and the individual. Subtle variations of epicenters across disease stages suggest interacting pathological processes, while associations with patient-specific symptoms support additional inter-individual variability of hub vulnerability and epicenters in schizophrenia. Our work outlines potential pathways to better understand macroscale structural alterations, and inter- individual variability in schizophrenia.

Keywords
  • Humans
  • Schizophrenia / pathology
  • Schizophrenia / physiopathology
  • Connectome / methods
  • Adult
  • Female
  • Male
  • Magnetic Resonance Imaging / methods
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology
  • Nerve Net / pathology
  • Nerve Net / physiopathology
  • Nerve Net / diagnostic imaging
  • Brain / pathology
  • Brain / physiopathology
  • Middle Aged
  • Neural Pathways / physiopathology
  • Neural Pathways / pathology
  • Young Adult
Funding
  • NIMH NIH HHS [R01 MH118695]
  • NINDS NIH HHS [R01 NS114628]
  • NIBIB NIH HHS [R01 EB015611]
  • NINDS NIH HHS [RF1 NS114628]
  • NIMH NIH HHS [RF1 MH123163]
  • NIAAA NIH HHS [R01 AA012207]
  • NIMH NIH HHS [R01 MH121246]
  • NIH HHS [S10 OD023696]
  • CSRD VA [I01 CX000227]
  • NIMH NIH HHS [R01 MH112583]
  • NIMH NIH HHS [R01 MH116948]
  • NIMH NIH HHS [R21 MH097196]
Citation (ISO format)
GEORGIADIS, Foivos et al. Connectome architecture shapes large-scale cortical alterations in schizophrenia : a worldwide ENIGMA study. In: Molecular psychiatry, 2024, vol. 29, n° 6, p. 1869–1881. doi: 10.1038/s41380-024-02442-7
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Additional URL for this publicationhttps://www.nature.com/articles/s41380-024-02442-7
Journal ISSN1359-4184
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