Title: Neurostructural subgroup in 4291 individuals with schizophrenia identified using the subtype and stage inference algorithm

Keypoints: 

• Question- What is the pattern of brain atrophy progression associated with different schizophrenia biotypes?

• Findings- This study identify two distinct neurostructural subgroups by mapping the spatial and temporal ‘trajectory’ of gray matter change in schizophrenia. Subgroup 1 was characterized by an early cortical predominant loss with enlarged striatum, whereas subgroup 2 displayed an early subcortical-predominant loss in the hippocampus, striatum and other subcortical regions. It confirmed the reproducibility of the two neuro structural subtypes across various sample sites, including Europe, North America and East Asia.

• Meaning - This imaging-based taxonomy holds the potential to identify individuals with shared neurobiological attributes, thereby suggesting the viability of redefining existing disorder constructs based on biological factors.