Neuroimaging in schizophrenia: From group-average abnormalities to individualised circuit models.

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Traditional models of schizophrenia pathophysiology are challenged by recent findings.
• Schizophrenia is increasingly viewed as a complex disorder with heterogeneous origins.

Purpose of the Study:

• To synthesize advances in multimodal neuroimaging over the past five years.
• To refine models of schizophrenia pathophysiology based on converging evidence.

Main Methods:

• Narrative review of structural, diffusion, functional, molecular, and computational neuroimaging studies.
• Analysis of functional MRI, PET, MRS, and computational modeling data.
• Normative modeling and biologically informed subgrouping.

Main Results:

• Schizophrenia involves heterogeneous, developmentally anchored deviations in distributed neural circuits, manifesting as network instability.
• Individually variable patterns of alterations in cortical, white matter, and thalamic subnuclei are observed.
• Impaired regulation across multiple brain systems (salience, default mode, executive, thalamocortical) and subregion-specific neurochemical abnormalities are implicated.

Conclusions:

• Schizophrenia is a dynamically evolving circuit disorder, bridging molecular dysfunction and clinical expression.
• Network instability may arise from diverse developmental perturbations across cortico-striato-thalamo-cortical circuits.
• Future research requires longitudinal, harmonized, and multimodal study designs for mechanism-informed stratification.