학술논문
Neuroimaging biomarkers define neurophysiological subtypes with distinct trajectories in schizophrenia
Document Type
Original Paper
Author
Jiang, Yuchao; Wang, Jijun; Zhou, Enpeng; Palaniyappan, Lena; Luo, Cheng; Ji, Gongjun; Yang, Jie; Wang, Yingchan; Zhang, Yuyanan; Huang, Chu-Chung; Tsai, Shih-Jen; Chang, Xiao; Xie, Chao; Zhang, Wei; Lv, Jinchao; Chen, Di; Shen, Chun; Wu, Xinran; Zhang, Bei; Kuang, Nanyu; Sun, Yun-Jun; Kang, Jujiao; Zhang, Jie; Huang, Huan; He, Hui; Duan, Mingjun; Tang, Yingying; Zhang, Tianhong; Li, Chunbo; Yu, Xin; Si, Tianmei; Yue, Weihua; Liu, Zhening; Cui, Long-Biao; Wang, Kai; Cheng, Jingliang; Lin, Ching-Po; Yao, Dezhong; Cheng, Wei; Feng, Jianfeng
Source
Nature Mental Health. 1(3):186-199
Subject
Language
English
ISSN
2731-6076
Abstract
Technical developments and improved access to neuroimaging techniques have brought us closer to understanding the neuropathological origins of schizophrenia. Using data-driven disease-progression modelling on cross-sectional magnetic resonance imaging (MRI) from 1,124 patients with schizophrenia, we characterize two distinct but stable ‘trajectories’ of brain atrophy, separately beginning in the Broca’s area (subtype1) and the hippocampus (subtype2). The two trajectories are replicated in cross-validation samples. Individuals within each subtype are further classified into two stages (‘pre-atrophy’ and ‘post-atrophy’). These subtypes show different atrophy patterns and symptom profiles. Longitudinal data from 523 patients with schizophrenia treated by antipsychotics only or adjunct transcranial magnetic stimulation (TMS) reveal that antipsychotics-only effects relate to phenotypic subtype (more effective in the subtype1) while adjunct transcranial-magnetic-stimulation effects relate to the stage (superior outcomes in the pre-atrophy stage). These findings suggest distinct pathophysiological processes underlying schizophrenia that potentially yield to stratification and prognostication—a key requirement for personalizing treatments in enduring illnesses.
Using data-driven disease-progression modelling, Jiang, Wang, Zhou et al. characterized and replicated two distinct ‘trajectories’ of brain atrophy in patients with schizophrenia.
Using data-driven disease-progression modelling, Jiang, Wang, Zhou et al. characterized and replicated two distinct ‘trajectories’ of brain atrophy in patients with schizophrenia.