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Psychiatry Research: Neuroimaging

Elsevier BV

Preprints posted in the last 90 days, ranked by how well they match Psychiatry Research: Neuroimaging's content profile, based on 16 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Anterior Cingulate Cortex Sulcal Patterns associated with Catatonia across Schizophrenia and Mood Disorders

Moyal, M.; Consoloni, T.; Haroche, A.; Sebille, S. B.; Belhabib, D.; Ramon, F.; Henensal, A.; Dadi, G.; Attali, D.; Le Berre, A.; Debacker, C.; Krebs, M.-O.; Oppenheim, C.; Chaumette, B.; Iftimovici, A.; Cachia, A.; Plaze, M.

2026-04-22 psychiatry and clinical psychology 10.64898/2026.04.20.26351285 medRxiv
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Catatonia is a severe psychomotor syndrome that occurs across psychiatric diagnoses and is increasingly conceptualized as reflecting neurodevelopmental vulnerability. The anterior cingulate cortex (ACC) plays a central role in motor initiation and cognitive-affective integration and displays substantial interindividual variability in its sulcal morphology, which is established prenatally and remains stable across life. In this MRI study, we examined whether ACC sulcal patterns represent a structural trait marker of catatonia. We analyzed high-resolution T1-weighted images from a hospital-based cohort comprising patients with catatonia (N = 109), psychiatric patients without catatonia (N = 323), and healthy controls (N = 91). The presence of the paracingulate sulcus (PCS) in each hemisphere was determined through blinded visual inspection, and regression analyses tested associations with diagnostic group, adjusting for age, sex, scanner type, intracranial volume, and benzodiazepine and antipsychotic exposure. Patients with catatonia exhibited a significantly reduced prevalence of the left PCS and diminished hemispheric asymmetry compared with both non-catatonic patients and healthy controls. These effects were independent of whether catatonia occurred within psychotic or mood disorders. PCS size did not differ across groups, and sulcal pattern did not correlate with catatonia severity among affected individuals. The findings demonstrate that ACC sulcal deviations are specifically associated with catatonia across diagnostic categories, supporting a neurodevelopmental etiology and reinforcing ACC involvement in its pathophysiology. Early-determined sulcal morphology may represent a trait-level marker contributing to vulnerability for catatonia, with implications for early identification, risk stratification, and targeted intervention strategies.

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Disrupted Emotional Neural Synchrony in Schizophrenia Revealed by Intersubject Correlation of Naturalistic fMRI

Pallavicini, C.; Costanzo, E. Y.; de la Fuente, L. A.; Castro, M. N.; Guinjoan, S. M.; Tagliazucchi, E.; Villarreal, M.

2026-04-14 neuroscience 10.64898/2026.04.13.718247 medRxiv
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BackgroundSchizophrenia is marked by impairments in emotional processing and social cognition, yet traditional neuroimaging paradigms often lack the ecological validity to capture these deficits in real-world contexts. MethodsIn this study, we used intersubject correlation (ISC) analysis of functional MRI data to examine shared neural representations of naturalistic visual narratives in individuals with schizophrenia and healthy controls. Participants viewed short films designed to evoke happy, sad, and emotionally neutral responses, allowing us to compare how synchronized brain activity varied with emotional content across and within groups. ResultsHealthy controls showed greater ISC in regions associated with affective salience, emotion recognition, and social understanding, including the amygdala, insula, and temporal cortices. In contrast, participants with schizophrenia displayed higher synchrony in visual, subcortical, and frontal areas, suggesting a reliance on perceptual and executive systems. To isolate the effects of emotion from general visual processing, we compared ISC during emotional clips relative to neutral videos. This revealed significantly reduced synchrony in the bilateral amygdala in patients, highlighting a core dysfunction in affective engagement. Interestingly, neutral stimuli elicited unexpectedly strong synchronization in frontal and limbic regions in the schizophrenia group, possibly reflecting altered salience attribution to ambiguous or emotionally ambiguous content. ConclusionsThese results point to a functional reorganization of affective processing in schizophrenia, where impaired limbic recruitment is accompanied by compensatory engagement of perceptual and cognitive control networks. ISC during naturalistic stimulation emerges as a powerful tool for capturing subtle disruptions in shared emotional experience in psychiatric populations.

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Individuals with Intermittent Explosive Disorder Exhibit Idiosyncratic Neural Responses during Social-emotional Processing

Chen, J.; Keedy, S.; Coccaro, E.; Leong, Y. C.

2026-03-17 neuroscience 10.64898/2026.03.13.711681 medRxiv
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Intermittent explosive disorder (IED) is associated with impulsive aggression in ambiguous social contexts. Prior neuroimaging studies have treated IED as a homogenous group, but identical social situations may elicit divergent responses across IED individuals. Here, we test the hypothesis that IED is characterized by idiosyncratic neural responses to social cues during naturalistic social-emotional processing. IED individuals and healthy controls completed a validated paradigm where they were presented with video vignettes of interpersonal interactions while undergoing fMRI. We computed the intersubject correlation (ISC) in neural time courses between pairs of participants to quantify neural similarity, and assessed whether similarity differed between Healthy-Healthy and IED-IED dyads using Bayesian multilevel models, controlling for self-reported emotional responses and intention attributions for each vignette. Healthy-Healthy dyads showed significantly higher ISC than IED-IED dyads, indicating that neural responses to the videos were similar among healthy participants, but idiosyncratic in IED individuals. These effects were observed in regions in the default mode and salience networks, including the precuneus, medial prefrontal cortex, superior temporal sulcus, insula, and dorsal anterior cingulate cortex. Individuals with IED exhibited idiosyncratic neural responses during naturalistic social-emotional processing, even after accounting for differences in emotional reaction and intention attribution. This neural idiosyncrasy may reflect atypical integration of social cues, giving rise to maladaptive interpretations and impulsive aggression. Assessing neural synchrony during ecologically valid paradigms offers a promising tool for identifying neural markers of interpersonal dysfunction and informing targeted interventions.

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Distinct Connectivity Signatures of Hallucinatory Experiences and Neuromelanin Signal in Adolescents

Tubiolo, P. N.; Patel, Y.; Trepiccione, A.; Jonas, K.; Moeller, S. J.; Abi-Dargham, A.; Kotov, R.; Van Snellenberg, J. X.; Perlman, G.

2026-05-13 psychiatry and clinical psychology 10.64898/2026.05.10.26352847 medRxiv
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ObjectiveLate adolescence is a critical developmental period that typically precedes psychosis onset, yet the neural correlates of subclinical hallucinatory experiences that may impact psychosis risk are poorly understood. Given evidence from adult psychosis models implicating abnormal "triple network" connectivity among the frontoparietal (FPN), default mode (DMN) and salience/cingulo-opercular (CON) networks, as well as dopaminergic abnormalities, we examined whether hallucinatory experiences in adolescents are associated with altered triple network organization and dopamine-related measures in the midbrain. MethodsWe performed a cross-sectional analysis of 171 community adolescents aged 14-17 who underwent resting-state functional magnetic resonance imaging and neuromelanin-sensitive MRI. Hallucinatory experience severity was measured using the Specific Psychotic Experiences Questionnaire. Resting-state functional connectivity was calculated among a priori DMN, FPN, and CON cortical regions; we examined associations between connectivity, hallucinatory experience severity, within-network connectivity, system segregation, and neuromelanin signal in the ventral tegmental area (VTA). ResultsGreater hallucinatory experience severity was associated with stronger connectivity in a subnetwork composed of CON-DMN and CON-FPN edges. Greater hallucinatory experience severity was also associated with lower global network segregation. VTA neuromelanin signal was not directly associated with hallucinatory experience severity, but greater VTA signal predicted lower connectivity in the hallucination-related subnetwork. Greater VTA neuromelanin signal was also associated with a distinct pattern of stronger connectivity within DMN midline regions. ConclusionsThese findings implicate altered triple network organization in hallucinatory experiences during late adolescence and suggest that dopamine-related midbrain signal may reflect broader developmental variation in cortical network organization rather than symptom severity directly. Plain Language SummaryHallucinatory experiences during adolescence may signal increased risk for later psychotic disorders, but their brain basis is unclear. We studied 171 adolescents aged 14-17 using resting-state fMRI to measure brain network activity and neuromelanin-sensitive MRI to estimate dopamine-related midbrain signal. More severe hallucinatory experiences were linked to abnormal communication among three brain networks often implicated in psychosis. Dopamine-related signal was not directly related to hallucination severity but was associated with developmentally relevant network organization. Overall, this work serves to improve our understanding of the risk factors that may contribute to psychosis conversion in adulthood.

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Shared brain basis for altered self-referential processing across psychiatric disorders? A systematic review and meta-analysis of neuroimaging studies

Zhu, S.; Yan, W.-J.; Chuan-Peng, H.

2026-03-17 neuroscience 10.64898/2026.03.13.711269 medRxiv
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Self-referential processing is a fundamental cognitive function, and abnormalities in its neural implementation have been reported across a range of psychiatric disorders, leading to the proposal that such alterations may constitute a transdiagnostic neurobiological feature. Yet claiming transdiagnostic requires rigorous evidence. Here, we examined the evidence for such a hypothesis by conducting a systematic review and coordinate-based meta-analysis of psychiatric neuroimaging studies that employed self-referential tasks. The systematic review identified 36 neuroimaging studies across 9 broad categories of psychiatric disorders, suggesting that the neural aberrancy of self-referential processing is indeed of great interest across different diagnosis. Of these, 27 studies were eligible for the ALE meta-analysis. The ALE results revealed hypoactivation of the right precuneus in psychiatric groups relative to health controls, alongside hyperactivation of the right triangular part of the inferior frontal gyrus (IFGtri) during self-referential processing in psychiatric groups. Notably the precuneus and IFGtri are core nodes of the default mode network and the frontal-parietal control network, respectively, suggesting that aberrant self-referential processing across psychiatric disorders may be characterized by disrupted default mode network engagement accompanied by compensatory or maladaptive recruitment of control-related frontal regions. Together, our findings revealed a strong research interest in neural aberrancy of self-referential processing as a transdiagnostic feature. However, available evidence only provided preliminary evidence for such statement. To move forward, the field needs coordinated efforts to systematically accumulate data and collecting new datasets.

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Naturalistic acceptance-based emotion regulation in adolescents with NSSI: altered prefrontal activation and amygdala-prefrontal connectivity

Jiang, H.; He, J.; Li, L.; Guo, Y.; Gan, X.; Fan, X.; Wang, X.; Ferraro, S.; Vatansever, D.; Kendrick, K. M.; Keysers, C.; Gazzola, V.; Zhou, B.; Becker, B.

2026-05-04 radiology and imaging 10.64898/2026.05.03.26352312 medRxiv
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BackgroundNon-suicidal self-injury (NSSI) represents a growing public health concern, particularly in adolescents. Emotion dysregulation is central to prevailing NSSI models, yet it remains unclear whether acceptance-based emotion regulation (ER) and its underlying neural processes are disrupted in naturalistic, dynamic contexts. MethodsPre-registered neuroimaging trial in recently diagnosed and treatment-naive adolescents with NSSI (n=25) and healthy controls (n=25) using an ER paradigm with dynamic video clips and concomitant functional magnetic resonance imaging. Behavioral, neural activity, and connectivity indices during emotion reactivity and acceptance-based regulation were compared between groups. ResultsAdolescents with NSSI experienced elevated negative feelings during neutral clips, reflecting heightened baseline negativity. In comparison to controls, they displayed reduced temporal and ventrolateral prefrontal engagement during emotional reactivity, but increased engagement of regions implicated in both emotion reactivity (right amygdala, insula) and ER (right dlPFC, dmPFC, vlPFC) when utilizing acceptance. Higher activation in the right dlPFC was positively associated with difficulties in accessing ER strategies in everyday life. Adolescents with NSSI showed reduced functional connectivity between the right amygdala and left dlPFC. ConclusionsAdolescents with NSSI exhibited a baseline negativity bias and altered neural engagement during both negative emotional reactivity and acceptance-based regulation, characterized by increased activation and reduced amygdala-dlPFC connectivity. These findings highlight atypical emotion processing in real-life contexts in individuals with NSSI. Targeting acceptance-based regulation and prefrontal-limbic circuitry may represent a promising intervention approach for adolescents with NSSI.

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Disrupted Coupling of Heart Rate Dependent Brain Network Switching and Attentional Task Performance in Schizophrenia Spectrum Disorders

Kundert-Obando, K.; Kittleson, A.; Wang, S.; Pourmotabbed, H.; Provancher, E.; Machado, A.; Park, S.; Sheffield, J. M.; Ward, H. B.

2026-04-07 psychiatry and clinical psychology 10.64898/2026.04.06.26350241 medRxiv
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Cognitive deficits are a core feature of schizophrenia, yet their neural mechanisms remain poorly understood. Network switching, a measure of how frequently brain networks change their interactions over time, has been linked to cognitive performance in healthy individuals and has been reported to be altered in schizophrenia. Recent evidence further suggests that the relationship between network switching and cognition depends on arousal, which is itself disrupted in schizophrenia. However, whether arousal-related alterations in network switching contribute to cognitive impairment in schizophrenia remains unclear. Here, we used concurrent resting-state functional MRI (fMRI) and pulse oximetry data from 39 healthy controls (HC), 27 psychiatric controls (PC), and 39 individuals with schizophrenia spectrum disorders (SSD) to examine whether network switching relates to indices of autonomic arousal. Additionally, in HC and SSD participants, we tested whether arousal moderated the association between network switching and performance on an attention task. We observed no group differences in autonomic arousal. However, PC exhibited higher dorsal default mode and anterior salience network switching rates compared to SSD participants. Additionally, autonomic arousal significantly moderated the relationship between network switching and cognitive performance in HC, an effect that was absent in SSD. Notably, these findings implicate network switching as a potential neural biomarker that differentiates PC from SSD. They also suggest that disrupted coupling between arousal state and network switching, rather than switching alone, may underlie cognitive dysfunction in SSD.

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Examining comorbid and transdiagnostic depression clinical outcomes across anxiety, autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, depression, and schizotypal personality groups: a novel NeuroMark SPECT approach

Harikumar, A.; Baker, B. T.; Amen, D.; Keator, D.; Calhoun, V.

2026-04-17 psychiatry and clinical psychology 10.64898/2026.04.15.26350953 medRxiv
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Major depressive disorder (MDD) is a highly prevalent neuropsychiatric disorder characterized by depressed mood, feelings of sadness, loss of interest, and reduced pleasure related to daily activities. The clinical etiology of depression has been extensively studied, with research indicating biological, social, and psychological factors related to onset of depressive symptoms. Despite increased knowledge related to MDD, there is no tangible biomarker developed for MDD. Neuroimaging modalities such as single photon emission computed tomography (SPECT) have been utilized to characterize regional cerebral perfusion (rCBF). Functional dysconnectivity in depressed patients have been examined, with depressed individuals showing elevated depression scores and decreased rCBF in cognition and executive functioning networks. While SPECT can be utilized to monitor rCBF changes with respect to symptom severity, it alone cannot be utilized to develop a potent biomarker. Advanced multivariate methods such as independent component analysis (ICA) have been used to visualize disconnected functional patterns across disorders including depression and schizophrenia. Given no current SPECT studies examine transdiagnostic clinical profiles, the current study aims to bridge this gap. We utilized the 68 NeuroMark SPECT template across six patient groups. Factor scores investigating three key symptoms of depression: worry/rumination, moodiness, and social disinterest, and measured the loading parameter strength (i.e. component expression for each NeuroMark domain/subdomain) across the 68 components were examined. We identified significant relationships between symptoms and frontal, triple network, sensorimotor, and visual components across the three symptom profiles. Future studies should examine these trends across larger sample sizes, and increased clinical samples.

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Fronto-limbic and Thalamocortical Network Alterations after COVID-19 Recovery: a Multimodal MRI Study

Mishra, S. S.; Misra, R.; Douaud, G.; Biswal, B.; Gandhi, T.

2026-05-22 radiology and imaging 10.64898/2026.05.19.26353613 medRxiv
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Background: Persistent neurological and cognitive symptoms following SARS-CoV-2 infection point to long-term alterations in brain structure and function. The thalamus, orbitofrontal cortex, and limbic networks are particularly susceptible to inflammatory and neurovascular stressors. However, the relationship between cortical, white-matter, and thalamocortical alterations in post-COVID syndrome remains unclear. Methods: 76 COVID-19 recovered participants (CRPs) and 51 healthy controls (HCs) underwent multimodal MRI comprising T1-weighted structural, diffusion, and resting-state functional acquisitions. Grey-matter morphology was assessed using voxel-based morphometry (VBM), white-matter microstructure using tract-based spatial statistics (TBSS), and thalamocortical functional connectivity (TC-FC) using seed-based analyses from major thalamic nuclei. Results were evaluated both across the groups (HC vs. CRP) and after stratifying CRPs by hospitalisation status (HC vs. Non-hospitalized patients (NHPs) vs. Hospitalized patients (HPs)). Results: No group-level grey-matter differences were observed between HCs and CRPs; however, HPs showed localized volume loss in the orbitofrontal and frontal-pole cortices (pFWE < 0.05). TBSS revealed widespread microstructural abnormalities, including reduced fractional anisotropy and mean diffusivity across association and commissural tracts (pcorr < 0.05), with regional increases in mode of anisotropy indicating selective loss of crossing fibres (pcorr < 0.05). Resting-state analyses revealed increased TC-FC from the mediodorsal thalamic nucleus to anterior cingulate, parietal, and occipital cortices (pcorr < 0.05), while differences in pulvinar and ventrolateral nuclei were not significant (pcorr > 0.05). Conclusions: Our findings indicate that COVID-19 recovery is associated with enduring alterations in fronto-limbic and thalamo-cortical circuits, most prominently in individuals with severe infection. Convergent structural and functional changes involving the orbitofrontal cortex and mediodorsal thalamus suggest network-specific reorganisation that may underpin persistent cognitive and affective symptoms of post-COVID syndrome.

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Tobacco Use is Related to Parietal-Hippocampal Connectivity in People at Clinical High Risk for Psychosis

Bai, Y.; Roeske, M. J.; Beermann, A.; Addington, J.; Bearden, C. E.; Cadenhead, K.; Cannon, T. D.; Carrion, R. E.; Cornblatt, B.; Keshavan, M.; Mathalon, D. H.; Perkins, D. O.; Seidman, L.; Stone, W. S.; Tsuang, M. T.; Walker, E. F.; Woods, S. W.; Brady, R. O.; Ward, H. B.

2026-05-28 psychiatry and clinical psychology 10.64898/2026.05.26.26354136 medRxiv
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Background: Tobacco use is prevalent in clinical high risk for psychosis (CHR-P) population and has widespread negative health consequences, but understanding of its neural substrates is limited. Abnormal default mode network (DMN) may underlie tobacco dependence in CHR-P. We investigated how tobacco use relates to DMN connectivity and how CHR-P status impacts this relationship. Methods: We used baseline substance use and resting-state functional magnetic resonance imaging data from the North American Prodrome Longitudinal Study (NAPLS2; CHR-P: n=211, mean age 19.2, 37.9% female; healthy control: n=132, mean age 19.9, 47.7% female). Voxel-wise connectivity was calculated from the left lateral parietal (LLP) node of the DMN to the rest of the brain. We regressed LLP-brainwide connectivity against tobacco use frequency in the past month to generate a spatial map of how connectivity relates to current tobacco use. Results: Brainwide connectivity analysis identified two clusters in R hippocampus (peak voxel at MNI [+30,-12,-27]) and in L parahippocampus (peak voxel at MNI [-27,-27,-27]), where higher LLP-cluster connectivity was associated with more frequent tobacco use. LLP - R hippocampus connectivity was higher in current tobacco users compared to non-tobacco users (t=-3.5466, df=101.88, p=0.0006), and higher in CHR-P than controls (t=-2.8651, df=279.47, p=0.0049). Among current tobacco users, there was a significant tobacco-by-diagnosis interaction on LLP - R hippocampus connectivity (estimate=0.306, SE=0.149, t=2.051, p=0.045) such that heavier tobacco use predicted hyperconnectivity only in CHR. Conclusions: More frequent tobacco use was associated with higher DMN-hippocampal connectivity in both CHR-P and controls. CHR-P diagnosis enhanced this relationship.

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Heightened Distraction under Competition in Obsessive-Compulsive Disorder

McCain, K. J.; Ayomen, E.; Mirifar, A.; Simpson Martin, H.; Demeterfi, D.; McNeil, D. J.; DePamphilis, G.; Hatem, R.; Nelson, R.; Melville, G.; Hammes, E.; Lee, A.; McCarty, R.; Lee, M.; Paciotti, C.; Coutinho, P.; Mathews, C. A.; Keil, A.

2026-03-17 neuroscience 10.64898/2026.03.15.711932 medRxiv
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The identification of objective, dimensional indices of mental health is of central importance in the pursuit of transdiagnostic multi-dimensional frameworks of psychopathology. Altered visual processing occupies a specific domain of interest and motivated the present investigation aimed to quantify the visuocortical impact of affective naturalistic distractor cues on limited capacity attentional resources in obsessive-compulsive disorder (OCD). The current investigation examined the extent to which attentional resources are allocated toward task cues under affective and disorder-relevant distraction in participants with OCD (N = 33) and control participants (N = 31). Steady-state visual evoked potentials (ssVEPs) in response to task-relevant cues were examined using a foreground task where participants detected coherent motion in a flickering random dot kinematogram (RDK) overlaid on naturalistic distractor pictures ranging in emotional content (pleasant, neutral, unpleasant, and OCD-evoking pictures). Amplitude envelopes of ssVEPs in response to the motion stimulus served as an index of visuocortical engagement with task-relevant cues. Data were also fitted to the distraction under competition model (DUC), a computational framework of attention selection. Group differences emerged with stronger visuocortical competition effects (attenuated task engagement) for the OCD group, driven largely by the unpleasant pictures, followed by the OCD-evoking pictures. Furthermore, the DUC model fit well in both groups, demonstrated the dominance of the visuocortical competition observed in response to the unpleasant pictures, and revealed the presence of substantial competition in response to the OCD-evoking pictures in the OCD group.

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Structural Brain Network Alterations in Relation to Treatment and Illness Severity in Bipolar Disorder

Nabulsi, L.; Kang, M. J. Y.; Jahanshad, N.; McPhilemy, G.; Martyn, F. M.; Haarman, B.; McDonald, C.; Hallahan, B.; O'Donoghue, S.; Stein, D. J.; Howells, F. M.; Scheffler, F.; Temmingh, H. S.; Glahn, D. C.; Rodrigue, A.; Pomarol-Clotet, E.; Vieta, E.; Radua, J.; Salvador, R.; Karuk, A.; Canales-Rodriguez, E. J.; Houenou, J.; Favre, P.; Polosan, M.; Pouchon, A.; Brambilla, P.; Bellani, M.; Mitchell, P. B.; Roberts, G.; Dannlowski, U.; Borgers, T.; Meinert, S.; Flinkenflugel, K.; Repple, J.; Lehr, E. J.; Grotegerd, D.; Hahn, T.; Wessa, M.; Phillips, M. L.; Teutenberg, L.; Kircher, T.; Straube, B

2026-03-31 neuroscience 10.64898/2026.03.28.714565 medRxiv
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BackgroundLarge-scale T1-weighted MRI studies have established grey-matter abnormalities in bipolar disorder (BD), with our group contributing to consensus findings. However, structural connectivity, particularly within emotion- and reward-related circuits, remains poorly understood. Diffusion-weighted MRI (dMRI) enables investigation of white-matter pathways, yet prior work is constrained by small samples, methodological heterogeneity, and unclear medication effects. We conducted the largest dMRI network analysis in BD, relating symptom burden and polypharmacy to tractography-derived connectivity and graph-theoretic metrics. MethodsCross-sectional structural and diffusion MRI scans from 449 individuals with BD (35.7{+/-}12.6 years) and 510 controls (33.3{+/-}12.6 years), aged 18-65, were analyzed across 16 ENIGMA-BD sites. Standardized segmentation/parcellation and constrained spherical deconvolution tractography generated individual structural connectivity matrices. Graph-theoretic metrics of global and subnetwork organization were related to symptom severity and medications. ResultsBD showed widespread network alterations (lower density and efficiency, longer path length, and higher betweenness centrality), altered microstructural organization in a limbic-basal ganglia circuit, and abnormal streamline counts in a default-mode/salience/fronto-limbic-basal ganglia network. Longer illness duration, later onset, and psychosis history were associated with greater abnormalities in network architecture, whereas more manic episodes were associated with greater fronto-limbic connectivity. Antidepressant (particularly SSRI), anticonvulsant, and antipsychotic use related to poorer global and fronto-limbic connectivity; no clear lithium effects emerged. ConclusionsAs the largest structural connectivity study in BD, we reveal widespread disruption in reward and emotion-regulation networks influenced by illness severity and medication use. Results show that multisite harmonization is feasible and highlight ENIGMA-BD as a scalable framework for identifying reproducible neurobiological markers.

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Anterior middle cingulate cortex gamma-aminobutyric acid level is elevated in children with both familial and prenatal alcohol exposure-associated attention deficit hyperactivity disorder

Alger, J. R.; Gupta, I.; Farkouh, L.; Korthas, J.; Shah, A.; Silverberg, A.; Salamon, N.; Schneider, B. N.; Joshi, S. H.; O'Connor, M. J.; O'Neill, J.

2026-05-26 psychiatry and clinical psychology 10.64898/2026.05.25.26354065 medRxiv
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Background: Prior neuroimaging suggests brain differences between children with attention deficit hyperactivity disorder due to prenatal alcohol exposure (ADHD+PAE) and non-exposed children with ADHD due to other, e.g., familial, causes (ADHD-PAE). There has been interest in regional brain levels of ;gamma-aminobutyric acid (GABA) and glutamate (Glu) measured in vivo with magnetic resonance spectroscopy (MRS) as possible indicators of local inhibitory, respectively, excitatory activity in ADHD. For the first time, we report here a comparison of GABA and Glu in ADHD+PAE vs. ADHD-PAE. Methods: At 3 T, we used J-difference-edited single-voxel MRS to assay GABA and Glu in 28 children with ADHD+PAE, 20 with ADHD-PAE, and 28 typically developing (TD) controls, all aged 8-14 years. MRS was sampled from midline anterior middle cingulate cortex (aMCC), the cognitive cingulate considered functionally relevant to ADHD. Spectra were fit with custom software, including a unique technique for isolating the GABA signal from the confounding macromolecular baseline (MMBL). Results: aMCC GABA was higher in ADHD+PAE and ADHD-PAE than in TD. GABA increased with age in TD, but not in ADHD+PAE or ADHD-PAE. Similar effects were observed for the ratios GABA/Glu and GABA/Glx. For GABA+MMBL (GABA+) these effects were not seen, rather GABA+ and MMBL increased with age for the ADHD+PAE group only. No significant effects were found for Glu or Glx. Conclusions: GABA in the aMCC does not distinguish the two etiologies of ADHD, rather elevated GABA that follows an abnormal developmental appears to be common to both. High GABA may reflect increased inhibition of the aMCC impairing its cognitive functions. GABA+ results in ADHD may not tract reliably with underlying GABA values. Negative results for Glu and Glx should be reexamined at shorter echo-times.

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Circadian-related hypothalamic structure differs by chronotype in bipolar disorder

Tahedl, M.; Rohrer, J.; Seifritz, E.; Smith, D. J.; Homan, P.

2026-03-07 psychiatry and clinical psychology 10.64898/2026.01.27.26344976 medRxiv
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BackgroundCircadian rhythm disturbances represent a core feature of bipolar disorder (BD), with evening chronotype as a marker for poorer outcomes. We hypothesized that BD psychopathology combined with evening chronotype is associated with structural alerations in circadian-related hypothalamic regions - particularly the suprachiasmatic nucleus (SCN) - specific to BD relative to other psychiatric diagnoses. MethodsWe investigated structural neuroimaging data from the UK Biobank (113 BD, 205 major depressive disorder, 91 psychotic disorders, 199 healthy controls). The SCN-containing anterior-inferior hypothalamic subunit was segmented, central to circadian functional neuroanatomy. For each group, diagnosis x chronotype interactions on its volume were tested using analysis of variance, with post-hoc estimated marginal means and correction for multiple comparisons. Covariates included age, sex, handedness, and lithium use. Specificity was examined across four additional hypothalamic subunits. ResultsThere was a diagnosis x chronotype interaction in the SCN-containing anterior-inferior hypothalamic subunit volume (F(6, 590) = 2.87, p =.009). This was driven by larger volumes in BD individuals with evening versus morning chronotype (t = 3.24, pFWER =.004). No comparable results were found in other hypothalamic regions or diagnoses. ConclusionsHypothalamic structure differs by chronotype in BD, with chronotype related associations localized to an anterior-inferior hypothalamic region implicated in circadian regulation. These findings support chronotype as a biologically meaningful dimension of variation in BD and provide neuroanatomical evidence linking circadian preference to circadian relevant brain structure. Longitudinal and interventional studies will be important to clarify the temporal dynamics, underlying mechanisms, and potential clinical significance of these associations.

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A psychometric evaluation of diffusion basis spectrum imaging indicates white matter inflammation in depression

Kaluza, L.; Kühnel, A.; Kuskova, E.; Studener, K.; Rommel, D.; Lieberz, J.; Kroemer, N. B.

2026-03-27 psychiatry and clinical psychology 10.64898/2026.03.25.26349306 medRxiv
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An inflammatory subtype of major depressive disorder (MDD) is associated with treatment resistance pointing to an unmet need for adjunctive treatments. To evaluate treatment-related changes in brain inflammation, diffusion basis spectrum imaging (DBSI) is a promising non-radiation-based technique for longitudinal designs which has been verified with histopathology. However, its use as an endpoint in clinical trials is dependent on its individual-level reliability to robustly track changes. Here, we evaluated two DBSI runs acquired in 94 participants (including 43 participants with MDD) on the same day about 1.5 h apart to assess short-term test-retest reliability. Fiber fraction (reflecting axonal/dendrite density) and hindered fraction (reflecting edema) showed moderate to high test-retest reliability in both gray and white matter regions, whereas restricted fraction (reflecting cellularity) showed lower values in gray and white matter. Group-level reliability was similar in participants with MDD, except for lower reliability of hindered fraction in gray matter. Re-identification rates of individual brain maps were higher using voxel-level white matter signatures compared to gray matter regions of interest (ROIs) (p<.001). Crucially, participants with MDD showed reduced fiber fraction (tmax=4.68, k=38) and elevated hindered fraction (tmax=4.74, k=32) in the cingulate bundle, consistent with increased white matter inflammation, while gray matter ROI-based classification failed to identify cases. We conclude that DBSI is a promising technique to track inflammatory signatures in MDD, particularly in white matter tracts. Since several frontal and subcortical gray matter ROIs showed insufficient reliability, their assessment would require multiple DBSI runs to provide robust estimates.

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Reliance on Prior Expectations in Psychosis: A Systematic Review and Meta-Analysis of Perceptual Tasks

Miller-Silva, C.; Illingworth, B. J.; Martey, K.; Mujirishvili, T.; de Beer, F.; Siskind, D.; Murray, G. K.

2026-04-01 psychiatry and clinical psychology 10.64898/2026.03.31.26349835 medRxiv
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Background: The highly influential predictive processing theory of psychosis posits that symptoms arise from imbalances in the weighting of predictions (priors) and sensory evidence. Despite this theory's increasing prominence, studies often present conflicting results. This is particularly problematic as findings from single tasks with modest sample sizes are frequently used to advance a theory for a generalised altered reliance on priors in psychosis. Methods: This study presents a random-effects, multi-level meta-analysis (PROSPERO CRD42024574379) evaluating evidence for aberrant reliance on priors in psychosis across perceptual tasks. The search identified articles in Embase, MEDLINE, APA PsycINFO, and APA PsycArticles published between 1st January 2005 and 31st October 2024, with risk of bias assessed using the Newcastle-Ottawa Scale. Included articles (34 results from 27 studies) compared adults with schizophrenia-spectrum psychosis (SZ; n = 904) to healthy controls (n = 1,039) on behavioural measures representing reliance on priors. Results: Results provided no evidence for atypical reliance on priors in psychosis (g = .03, 95% CI [-0.27, 0.34]; p = .818) or associations with delusions (6 results; SZ = 183; r = -.16, 95% CI [-0.51, 0.19]; p = .293) or hallucinations (10 results; SZ = 370; r = .04, 95% CI [-0.28, 0.36]; p = .780). In contrast with the theory that psychosis may differentially affect priors at different levels of the cognitive hierarchy, a sub-group analysis indicated that a two-level hierarchical model of priors did not account for conflicting results (F(1,32) = 0.1, p = .758). Conclusion: These findings do not suggest that psychosis is associated with a generalised predictive processing deficit spanning multiple aspects of perception. Key words: psychosis, schizophrenia, predictive processing, prior expectations, perception

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Are executive function and neuroanatomy in ADHD modulated by bilingualism?

Oak, A.; Gutierrez-Schieferl, I. S.; Eden, G. F.

2026-05-14 neuroscience 10.64898/2026.05.13.724877 medRxiv
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It has been proposed that bilinguals have better executive function (EF) arising from the constant selection of one language while inhibiting the other, and gray matter has been found to differ in bilinguals in regions linked to EF (frontal-parietal and subcortical structures). Attention Deficit Hyperactivity Disorder (ADHD) is associated with poorer EF and neuroanatomical differences underlying EF. Given the EF advantage in bilinguals, we investigated whether a bilingual experience affects EF performance and brain structure differentially in those with ADHD. Using the Adolescent Brain and Cognitive Development Study, we compared early Spanish-English bilinguals and English-speaking monolinguals with and without ADHD. ANOVAs for the Flanker, Working Memory, and Card Sort Tasks revealed no main effects of Language Experience (Bilingual versus Monolingual), a main effect of Diagnostic Group for Card Sort (ADHD worse than Controls), and no interaction effects on performance for any task. ANOVAs for gray matter volume (GMV) revealed a main effect of Language Experience in many regions, a main effect of Diagnostic Group in some regions, but no interactions. GMV in left thalamus was affected by both ADHD and bilingualism, but the effect of ADHD was not significantly diminished or enhanced by the dual-language experience. For cortical thickness, there was a main effect of Language Experience in several regions, no main effect of Diagnostic Group, and no interactions. Taken together, bilingualism has some impact on EF performance, a strong impact on neuroanatomy, but there was no disproportionate impact by bilingualism on the differences caused by ADHD for any measure. Research HighlightsExecutive function and brain structure differ in ADHD and in bilinguals, prompting the need to investigate interactive effects. Bilingualism did not disproportionately affect performance differences in ADHD for executive function, nor for gray matter volume or for cortical thickness differences in ADHD. Gray matter volume was less in ADHD than non-ADHD, as well as greater in bilinguals than monolinguals in the left thalamus, but without interaction effect. These independent effects indicate that the brain basis of ADHD is not impacted by a dual-language experience.

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Predicting cognitive-behavioral therapy outcomes in obsessive-compulsive disorder from inhibitory control neural activity: A mega-analysis and machine learning study from the ENIGMA-OCD consortium

Dzinalija, N.; van den Heuvel, O. A.; Simpson, H. B.; Ivanov, I.; Alonso, P.; Bertolin, S.; Bruin, W.; Fortea, L.; Fullana, M. A.; Hagen, K.; Hansen, B.; Huijser, C.; Kvale, G.; Martinez-Zalacain, I.; Menchon, J. M.; Ousdal, O. T.; Soriano-Mas, C.; van der Straten, A. L.; Thomopoulos, S. I.; Thorsen, A. L.; Vilajosana, E.; ENIGMA-OCD Consortium, ; Stein, D. J.; Thompson, P. M.; Veer, I. M.; Vriend, C.; van de Mortel, L. A.

2026-03-15 psychiatry and clinical psychology 10.64898/2026.03.13.26348316 medRxiv
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ObjectiveCognitive behavioral therapy (CBT) is an effective first-line treatment for obsessive-compulsive disorder (OCD), yet it remains difficult to predict who will respond to this intervention. This study investigates associations between neural activity during inhibitory control tasks and CBT outcomes, and whether task-based fMRI data could serve as a predictive marker of individual CBT response. MethodsUsing fMRI data from individuals performing an inhibitory control task across five samples (n=130, age range=8-57, 54% female) of the ENIGMA-OCD consortium, univariate associations were analyzed between activity during response inhibition and error processing and three CBT outcomes: response, remission, and pre-post treatment change in symptom severity. Random forest and support vector machine models using leave-one-sample-out cross-validation were used for prediction of CBT response and remission from fMRI activity and clinical data. ResultsRemission after CBT was associated with weaker activity in default mode regions during response inhibition and in the right supramarginal gyrus during error processing. Greater symptom reduction was linked to weaker pre-treatment activity across frontoparietal, dorsal attention, visual, and subcortical regions during response inhibition, but to stronger default mode activity during error processing. Despite these robust group-level effects, machine learning models failed to predict individual outcomes above chance level with either neuroimaging or clinical data. ConclusionWeaker activity during response inhibition in a widespread network, as well as stronger activity in default mode regions during error processing before treatment, appear beneficial to CBT response. However, these findings cannot yet be translated into individually predictive markers of CBT outcome.

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Cognitive Flexibility and Decision-Making in Anxiety and Depression: Meta-Analytic Evidence Facilitated by Machine-Learning Screening

Balcazar, J.; Albanese, B.; Rymer, T.; Davis, M.; Campos, S.; Polimerou, M.; Abel, E.; Shapley, J.; Algranatti, I.; Wood, H.; Smith, H.; Hankamer, K.; Orr, J.

2026-05-18 psychiatry and clinical psychology 10.64898/2026.05.14.26353209 medRxiv
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The ability to adjust to changing environments (cognitive flexibility) and optimal decision-making are pivotal brain functions that govern successful human behavior. Anxiety and depressive disorders are strongly pervasive psychiatric conditions across the lifespan that profoundly disrupt mechanisms of attention, working memory, and decision-making. Although existing task evidence documents impaired decision-making and flexibility outcomes for both anxiety and depression, there is a growing need to systematically evaluate the role of anxiety and depression and to quantitatively compare the effects of these disorders on these domains. In the present study, we conducted a meta-analysis of anxiety and depression on decision-making and cognitive flexibility. We utilized a random-effects approach, given that a large amount of between-subject heterogeneity was anticipated. Given the scope of this meta-analysis, we used the machine learning tool asReview to more efficiently conduct a meta-analytic search. Across all outcomes, results showed anxiety and depression were associated with reduced cognitive flexibility and decision-making. These effect sizes were then tested for significance using a fixed-effects (plural) model. Subgroup analyses revealed no significant differences between anxiety and depression for either decision-making or flexibility outcomes, consistent with a transdiagnostic perspective. Results are contextualized in light of the biopsychosocial model and potential transdiagnostic factors.

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Conserved fiber topography of the anterior limb of the internal capsule in treatment-resistant psychiatric patients

El Jammal, R.; Suzuki, H.; Mattar, L. S.; Hamre, T.; Soubra, S.; Ryan, M. A.; Mathura, R. K.; Mathew, S. J.; Allawala, A.; Storch, E. A.; Vanegas Arroyave, N.; Banks, G. P.; Pouratian, N.; Patriat, R.; Goodman, W. K.; Provenza, N. R.; Sheth, S. A.; Bartoli, E.; Heilbronner, S. R.

2026-05-15 neuroscience 10.64898/2026.05.11.724148 medRxiv
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IntroductionThe anterior limb of the internal capsule (ALIC) is a major white matter highway connecting prefrontal cortical (PFC) regions to the thalamus, brainstem, and subthalamic nucleus. Structural and functional abnormalities within the ALIC circuit have been associated with many neuropsychiatric disorders, including obsessive-compulsive disorder (OCD) and depression, and deep brain stimulation (DBS) may provide effective treatment to some of these patients. However, it remains unclear whether the well-characterized topographic organization of the ALIC observed in healthy individuals and preclinical models is preserved in treatment-resistant psychiatric populations. MethodsWe first used diffusion tractography to evaluate the topography of PFC and subcortical fibers through the ALIC in patients with treatment-resistant OCD (n=18) and depression (n=5). In depression patients, we also evaluated ALIC topography using cerebro-cerebral evoked potentials (CCEPs) elicited by single-pulse electrical stimulation (SPES) of DBS leads in the ALIC and recordings in the ventral PFC (vPFC). ResultsThe topographic organization of PFC and subcortical projections is preserved in the ALIC among treatment-resistant psychiatric patients, consistent with patterns observed in healthy individuals and preclinical models. CCEP recordings in the ventral PFC showed a ventral ALIC to medial vPFC/dorsal ALIC to lateral vPFC response pattern in the left hemisphere, but not in the right. ConclusionOur findings confirm that topographic patterns within the ALIC previously identified using preclinical models and healthy controls are preserved in treatment-resistant psychiatric patients. Furthermore, by linking white matter topography to stimulation effects, this work supports more precise and individualized neuromodulatory strategies for neuropsychiatric disorders.