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Meta-Analysis
. 2025 Apr 1;182(4):373-388.
doi: 10.1176/appi.ajp.20230806. Epub 2025 Feb 26.

Estimating Multimodal Structural Brain Variability in Schizophrenia Spectrum Disorders: A Worldwide ENIGMA Study

Wolfgang Omlor  1 Finn Rabe  1 Simon Fuchs  1 Werner Surbeck  1 Giacomo Cecere  1 Gao-Yang Huang  1 Stephanie Homan  1 Nils Kallen  1 Foivos Georgiadis  1 Tobias Spiller  1 Erich Seifritz  1 Thomas Weickert  1 Jason Bruggemann  1 Cynthia Weickert  1 Steven Potkin  1 Ryota Hashimoto  1 Kang Sim  1 Kelly Rootes-Murdy  1 Yann Quide  1 Josselin Houenou  1 Nerisa Banaj  1 Daniela Vecchio  1 Fabrizio Piras  1 Federica Piras  1 Gianfranco Spalletta  1 Raymond Salvador  1 Andriana Karuk  1 Edith Pomarol-Clotet  1 Amanda Rodrigue  1 Godfrey Pearlson  1 David Glahn  1 David Tomecek  1 Filip Spaniel  1 Antonin Skoch  1 Matthias Kirschner  1 Stefan Kaiser  1 Peter Kochunov  1 Feng-Mei Fan  1 Ole A Andreassen  1 Lars T Westlye  1 Pierre Berthet  1 Vince D Calhoun  1 Fleur Howells  1 Anne Uhlmann  1 Freda Scheffler  1 Dan Stein  1 Felice Iasevoli  1 Murray J Cairns  1 Vaughan J Carr  1 Stanley V Catts  1 Maria A Di Biase  1 Assen Jablensky  1 Melissa J Green  1 Frans A Henskens  1 Paul Klauser  1 Carmel Loughland  1 Patricia T Michie  1 Bryan Mowry  1 Christos Pantelis  1 Paul E Rasser  1 Ulrich Schall  1 Rodney Scott  1 Andrew Zalesky  1 Andrea de Bartolomeis  1 Annarita Barone  1 Mariateresa Ciccarelli  1 Arturo Brunetti  1 Sirio Cocozza  1 Giuseppe Pontillo  1 Mario Tranfa  1 Annabella Di Giorgio  1 Sophia I Thomopoulos  1 Neda Jahanshad  1 Paul M Thompson  1 Theo van Erp  1 Jessica Turner  1 Philipp Homan  1
Affiliations
Meta-Analysis

Estimating Multimodal Structural Brain Variability in Schizophrenia Spectrum Disorders: A Worldwide ENIGMA Study

Wolfgang Omlor et al. Am J Psychiatry. .

Abstract

Objective: The clinical diversity of schizophrenia is reflected by structural brain variability. It remains unclear how this variability manifests across different gray and white matter features. In this meta- and mega-analysis, the authors investigated how brain heterogeneity in schizophrenia is distributed across multimodal structural indicators.

Methods: The authors used the ENIGMA dataset of MRI-based brain measures from 22 international sites with up to 6,037 individuals for a given brain measure. Variability and mean values of cortical thickness, cortical surface area, cortical folding index, subcortical volume, and fractional anisotropy were examined in individuals with schizophrenia and healthy control subjects.

Results: Individuals with schizophrenia showed greater variability in cortical thickness, cortical surface area, subcortical volume, and fractional anisotropy within the frontotemporal and subcortical network. This increased structural variability was mainly associated with psychopathological symptom domains, and the schizophrenia group frequently displayed lower mean values in the respective structural measures. Unexpectedly, folding patterns were more uniform in individuals with schizophrenia, particularly in the right caudal anterior cingulate region. The mean folding values of the right caudal anterior cingulate region did not differ between the schizophrenia and healthy control groups, and folding patterns in this region were not associated with disease-related parameters.

Conclusions: In patients with schizophrenia, uniform folding patterns in the right caudal anterior cingulate region contrasted with the multimodal variability in the frontotemporal and subcortical network. While variability in the frontotemporal and subcortical network was associated with disease-related diversity, uniform folding may indicate a less flexible interplay between genetic and environmental factors during neurodevelopment.

Keywords: Neuroimaging; Neuroscience; Schizophrenia Spectrum and Other Psychotic Disorders.

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Conflict of interest statement

Dr. Andreassen has served as a consultant for Cortechs.ai and has received speakers honoraria from Janssen, Lundbeck, and Sunovion. Dr. Seifritz has served as an adviser and provided educational lectures for Angelini, Janssen, Lundbeck, Mepha Pharma, Otsuka, Recordati, Sunovion, and Schwabe. Dr. P. Homan has received grants and honoraria from Boehringer Ingelheim, Janssen, Lundbeck, Mepha, Neurolite, and Novartis. The other authors report no financial relationships with commercial interests.

Update of

  • Estimating multimodal brain variability in schizophrenia spectrum disorders: A worldwide ENIGMA study.
    Omlor W, Rabe F, Fuchs S, Cecere G, Homan S, Surbeck W, Kallen N, Georgiadis F, Spiller T, Seifritz E, Weickert T, Bruggemann J, Weickert C, Potkin S, Hashimoto R, Sim K, Rootes-Murdy K, Quide Y, Houenou J, Banaj N, Vecchio D, Piras F, Piras F, Spalletta G, Salvador R, Karuk A, Pomarol-Clotet E, Rodrigue A, Pearlson G, Glahn D, Tomecek D, Spaniel F, Skoch A, Kirschner M, Kaiser S, Kochunov P, Fan FM, Andreassen OA, Westlye LT, Berthet P, Calhoun VD, Howells F, Uhlmann A, Scheffler F, Stein D, Iasevoli F, Cairns MJ, Carr VJ, Catts SV, Di Biase MA, Jablensky A, Green MJ, Henskens FA, Klauser P, Loughland C, Michie PT, Mowry B, Pantelis C, Rasser PE, Schall U, Scott R, Zalesky A, de Bartolomeis A, Barone A, Ciccarelli M, Brunetti A, Cocozza S, Pontillo G, Tranfa M, Di Giorgio A, Thomopoulos SI, Jahanshad N, Thompson PM, van Erp T, Turner J, Homan P. Omlor W, et al. bioRxiv [Preprint]. 2023 Nov 2:2023.09.22.559032. doi: 10.1101/2023.09.22.559032. bioRxiv. 2023. Update in: Am J Psychiatry. 2025 Apr 01;182(4):373-388. doi: 10.1176/appi.ajp.20230806. PMID: 37961617 Free PMC article. Updated. Preprint.

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