Schizophrenia is a complex and heterogeneous syndrome. Whether quantitative imaging biomarkers can identify discrete subgroups of patients as might be used to foster personalized medicine approaches for patient care remains unclear. Cross-sectional structural MR images of 163 never-treated first-episode schizophrenia patients (FES) and 133 chronically ill patients with midcourse schizophrenia from the Bipolar and Schizophrenia Network for Intermediate Phenotypes (B-SNIP) consortium and a total of 403 healthy controls were recruited. Morphometric measures (cortical thickness, surface area, and subcortical structures) were extracted for each subject and then the optimized subtyping results were obtained with nonsupervised cluster analysis. Three subgroups of patients defined by distinct patterns of regional cortical and subcortical morphometric features were identified in FES. A similar three subgroup pattern was identified in the independent dataset of patients from the multi-site B-SNIP consortium. Similarities of classification patterns across these two patient cohorts suggest that the 3-group typology is relatively stable over the course of illness. Cognitive functions were worse in subgroup 1 with midcourse schizophrenia than those in subgroup 3. These findings provide novel insight into distinct subgroups of patients with schizophrenia based on structural brain features. Findings of different cognitive functions among the subgroups support clinical differences in the MRI-defined illness subtypes. Regardless of clinical presentation and stage of illness, anatomic MR subgrouping biomarkers can separate neurobiologically distinct subgroups of schizophrenia patients, which represent an important and meaningful step forward in differentiating subtypes of patients for studies of illness neurobiology and potentially for clinical trials.

中文翻译：

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根据脑结构改变的模式对精神分裂症患者进行分型

精神分裂症是一种复杂且异质的综合征。定量成像生物标志物是否可以识别患者的离散亚组，以促进患者护理的个性化医学方法仍不清楚。来自双相和精神分裂症中间表型网络 (B-SNIP) 联盟的 163 名从未接受过治疗的首发精神分裂症患者 (FES) 和 133 名患有中期精神分裂症的慢性病患者和总共 403 名健康对照的横截面结构 MR 图像被招募。为每个受试者提取形态测量（皮质厚度、表面积和皮质下结构），然后通过非监督聚类分析获得优化的亚型结果。在 FES 中确定了由区域皮质和皮质下形态特征的不同模式定义的三个患者亚组。在来自多站点 B-SNIP 联盟的患者的独立数据集中发现了类似的三个亚组模式。这两个患者队列中分类模式的相似性表明，3 组类型在疾病过程中相对稳定。中段精神分裂症亚组 1 的认知功能比亚组 3 更差。这些发现为基于大脑结构特征的不同精神分裂症患者亚组提供了新的见解。亚组中不同认知功能的发现支持 MRI 定义的疾病亚型的临床差异。无论临床表现和疾病阶段如何，