title: Distinct Patterns of Cerebral Cortical Thinning in Schizophrenia: A Neuroimaging Data-Driven Approach.
abstract: Schizophrenia is an etiologically and clinically heterogeneous disorder. Although neuroimaging studies have revealed brain alterations in schizophrenia, most studies have assumed that the disorder is a single entity, neglecting the diversity of alterations observed in the disorder. The current study sought to explore the distinct patterns of altered cortical thickness in patients with schizophrenia and healthy individuals using a data-driven approach. Unsupervised clustering using self-organizing maps followed by a K-means algorithm was applied to regional cortical thickness data in 108 schizophrenia patients and 121 healthy controls. After clustering, the clinical characteristics and cortical thickness patterns of each cluster were assessed. Unsupervised clustering revealed that a 6-cluster solution was the most appropriate in this sample. There was substantial overlap between the patterns of cortical thickness in schizophrenia patients and healthy controls, although the distributions of the patients and controls differed across the clusters. The patterns of altered cortical thickness in schizophrenia exhibited cluster-specific features; patients within a cluster exhibited the most extensive cortical thinning, particularly in the medial prefrontal and temporal regions, while those in other clusters exhibited reduced cortical thickness in the medial frontal region or temporal lobe. Furthermore, in the schizophrenia group, extensive cortical thinning was correlated with a higher dosage of antipsychotic medication, while preserved cortical thickness appeared to be linked to less negative symptoms. This data-driven neuroimaging approach revealed distinct patterns of cortical thinning in schizophrenia, possibly reflecting the etiological heterogeneity of the disorder.
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Genichi
authors.initials: G
authors.lastname: Sugihara
authors.affiliation: Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Research and Educational Unit of Leaders for Integrated Medical System, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Oishi
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Shuraku
authors.initials: S
authors.lastname: Son
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kubota
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Murai
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D012559:Schizophrenia / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D000069558:Unsupervised Machine Learning
chemical_list: D014150:Antipsychotic Agents
keywords: cortical thickness; heterogeneity; schizophrenia; self-organizing map; unsupervised learning