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Morphological Profiling of Schizophrenia: Cluster Analysis of MRI-Based Cortical Thickness Data.

Abstract：

:The diagnosis of schizophrenia is thought to embrace several distinct subgroups. The manifold entities in a single clinical patient group increase the variance of biological measures, deflate the group-level estimates of causal factors, and mask the presence of treatment effects. However, reliable neurobiological boundaries to differentiate these subgroups remain elusive. Since cortical thinning is a well-established feature in schizophrenia, we investigated if individuals (patients and healthy controls) with similar patterns of regional cortical thickness form naturally occurring morphological subtypes. K-means algorithm clustering was applied to regional cortical thickness values obtained from 256 structural MRI scans (179 patients with schizophrenia and 77 healthy controls [HCs]). GAP statistics revealed three clusters with distinct regional thickness patterns. The specific patterns of cortical thinning, clinical characteristics, and cognitive function of each clustered subgroup were assessed. The three clusters based on thickness patterns comprised of a morphologically impoverished subgroup (25% patients, 1% HCs), an intermediate subgroup (47% patients, 46% HCs), and an intact subgroup (28% patients, 53% HCs). The differences of clinical features among three clusters pertained to age-of-onset, N-back performance, duration exposure to treatment, total burden of positive symptoms, and severity of delusions. Particularly, the morphologically impoverished group had deficits in N-back performance and less severe positive symptom burden. The data-driven neuroimaging approach illustrates the occurrence of morphologically separable subgroups in schizophrenia, with distinct clinical characteristics. We infer that the anatomical heterogeneity of schizophrenia arises from both pathological deviance and physiological variance. We advocate using MRI-guided stratification for clinical trials as well as case-control investigations in schizophrenia.

journal_name

Schizophr Bull

journal_title

Schizophrenia bulletin

authors

Pan Y,Pu W,Chen X,Huang X,Cai Y,Tao H,Xue Z,Mackinley M,Limongi R,Liu Z,Palaniyappan L

doi

10.1093/schbul/sbz112

subject

Has Abstract

pub_date

2020-04-10 00:00:00

pages

623-632

issue

eissn

0586-7614

issn

1745-1701

pii

5696773

journal_volume

pub_type

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Morphological Profiling of Schizophrenia: Cluster Analysis of MRI-Based Cortical Thickness Data.