Abstract
Identifying both the commonalities and differences in brain structures among psychiatric disorders is important for understanding the pathophysiology. Recently, the ENIGMA-Schizophrenia DTI Working Group performed a large-scale meta-analysis and reported widespread white matter microstructural alterations in schizophrenia; however, no similar cross-disorder study has been carried out to date. Here, we conducted mega-analyses comparing white matter microstructural differences between healthy comparison subjects (HCS; N = 1506) and patients with schizophrenia (N = 696), bipolar disorder (N = 211), autism spectrum disorder (N = 126), or major depressive disorder (N = 398; total N = 2937 from 12 sites). In comparison with HCS, we found that schizophrenia, bipolar disorder, and autism spectrum disorder share similar white matter microstructural differences in the body of the corpus callosum; schizophrenia and bipolar disorder featured comparable changes in the limbic system, such as the fornix and cingulum. By comparison, alterations in tracts connecting neocortical areas, such as the uncinate fasciculus, were observed only in schizophrenia. No significant difference was found in major depressive disorder. In a direct comparison between schizophrenia and bipolar disorder, there were no significant differences. Significant differences between schizophrenia/bipolar disorder and major depressive disorder were found in the limbic system, which were similar to the differences in schizophrenia and bipolar disorder relative to HCS. While schizophrenia and bipolar disorder may have similar pathological characteristics, the biological characteristics of major depressive disorder may be close to those of HCS. Our findings provide insights into nosology and encourage further investigations of shared and unique pathophysiology of psychiatric disorders.
Highlights
Classifying psychiatric disorders into distinct diagnoses remains challenging, Kraepelin dissociated schizophrenia and bipolar disorder more than a century
The number of diffusion tensor imaging (DTI) indices that the variability ratio was significantly higher compared with healthy comparison subjects (HCS) was larger in the order of schizophrenia, major depressive disorder, bipolar disorder, and autism spectrum disorder
Our study largely replicates the findings of the ENIGMASchizophrenia Working Group (Fig. 1) [34]
Summary
Classifying psychiatric disorders into distinct diagnoses remains challenging, Kraepelin dissociated schizophrenia and bipolar disorder more than a century. Extended author information available on the last page of the article ago While psychiatric disorders, such as schizophrenia, bipolar disorder, autism spectrum disorder, and major depressive disorder, display specific symptoms, many of their symptoms are shared by multiple disorders. Some prior studies have reported lower FA in the corpus callosum in individuals with major depressive disorder [7, 8] These white matter alterations have the potential to differentiate pathophysiological characteristics between psychiatric disorders. Organization) consortium, conducts a large, multisite, crosssectional investigation of white matter microstructural differences among healthy comparison subjects (HCS) and individuals with schizophrenia, bipolar disorder, autism spectrum disorder, and major depressive disorder by using mega-analytic methods similar to those of the study by. Among HCS and individuals with schizophrenia, bipolar disorder, autism spectrum disorder, and major depressive disorder
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