Neuroanatomical Deficits in Visual Cortex Subregions of Individuals With Psychosis Spectrum Disorders Linked to Symptoms, Cognition, and Childhood Trauma

Background and Hypothesis The visual system is a significant site of pathology in psychosis spectrum disorders (PSD). However, there is limited research investigating visual cortex (VC) subregions in this population. Using data from the Bipolar-Schizophrenia Network on Intermediate Phenotypes Consortium (BSNIP-1/BSNIP-2/PARDIP), this study examined structural measures in VC subregions in individuals with PSD (IwP). Study Design Cortical surface area and thickness in 5 VC subregions (hOc1, hOc2, hOc3v, hOc4v, MT) were quantified using FreeSurfer v7.1.0 and compared between IwP (n = 1211) and healthy controls (HC, n = 734). Regional specificity was examined by controlling for total surface area or mean thickness. ComBat was used to harmonize scanner effects. Associations between VC measures and symptom severity, cognition, and childhood trauma scores were assessed. Study Results IwP demonstrated smaller surface area in hOc1, hOc2, and hOc3v, and lower cortical thickness in all 5 VC subregions compared to HC. Thickness reductions in hOc1, hOc4v, and MT were regionally specific. hOc4v and MT were among the top 3 regions exhibiting the most robust thickness deficits (d = −0.38 to −0.40) across all VC and Desikan–Killiany brain regions. Lower thickness in mid-level visual subregions was associated with greater positive symptoms and poorer cognition. Childhood trauma scores were related to thickness alterations in VC subregions. Conclusions This study demonstrates that the VC is among the most profoundly affected brain regions in PSD. Different patterns of area and thickness alterations across early and mid-level visual subregions, along with varying associations with clinical measures, suggest distinct developmental and disease-related influences.