Heterogenous Patterns of Brain Atrophy in Schizophrenia Localize to A Common Brain Network

Abstract Understanding the neuroanatomy of schizophrenia remains elusive due to heterogenous findings across neuroimaging studies. Here, we investigated whether patterns of brain atrophy associated with schizophrenia would localize to a common brain network. Using the human connectome as a wiring diagram, we identified a connectivity pattern, a schizophrenia network, uniting heterogenous results from 90 published studies of atrophy in schizophrenia (total n>8,000). This network was specific to schizophrenia, differentiating it from atrophy in high-risk individuals (n=3038), normal aging (n=4,195), neurodegenerative disorders (n=3,707), and other psychiatric conditions (n=3,432). The network was also stable with disease progression and across different clusters of schizophrenia symptoms. Patterns of brain atrophy in schizophrenia were negatively correlated with lesions linked to psychosis-related thought processes in an independent cohort (n=181). Our results propose a unique, stable, and unified schizophrenia network, addressing a significant portion of the heterogeneity observed in prior atrophy studies.