Functional Connectivity Biomarkers in Schizophrenia

Schizophrenia is a debilitating neuropsychiatric disorder that affects approximately 1% of the population and poses a major public health problem. Despite over 100 years of study, the treatment for schizophrenia remains limited, partially due to the lack of knowledge about the neural mechanisms of the illness and how they relate to symptoms. The US Food and Drug Administration (FDA) and the National Institute of Health (NIH) have provided seven biomarker categories that indicate causes, risks, and treatment responses. However, no FDA-approved biomarkers exist for psychiatric conditions, including schizophrenia, highlighting the need for biomarker development. Over three decades, magnetic resonance imaging (MRI)-based studies have identified patterns of abnormal brain function in schizophrenia. By using functional connectivity (FC) data, which gauges how brain regions interact over time, these studies have differentiated patient subgroups, predicted responses to antipsychotic medication, and correlated neural changes with symptoms. This suggests FC metrics could serve as promising biomarkers. Here, we present a selective review of studies leveraging MRI-derived FC to study neural alterations in schizophrenia, discuss how they align with FDA-NIH biomarkers, and outline the challenges and goals for developing FC biomarkers in schizophrenia.