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Breaking the norm: population-scale deviations of brain structure in depression and anxiety

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Item Type:Preprint
Title:Breaking the norm: population-scale deviations of brain structure in depression and anxiety
Creators: Wiegert, Julius ORCID logoORCID: https://orcid.org/0009-0003-4518-1749, Marty-Lombardi, Sebastián ORCID logoORCID: https://orcid.org/0000-0001-8309-9875, Oweda, Jailan ORCID logoORCID: https://orcid.org/0009-0002-5721-6374, Lenz, Esra ORCID logoORCID: https://orcid.org/0009-0007-3175-7101, Ahnert, Peter ORCID logoORCID: https://orcid.org/0000-0002-1771-0856, Berger, Klaus ORCID logoORCID: https://orcid.org/0000-0001-8966-3684, Brenner, Hermann ORCID logoORCID: https://orcid.org/0000-0002-6129-1572, Frank, Josef ORCID logoORCID: https://orcid.org/0000-0003-4867-9465, Grabe, Hans ORCID logoORCID: https://orcid.org/0000-0003-3684-4208, Greiser, Karin Halina ORCID logoORCID: https://orcid.org/0000-0003-3213-8285, Klinger-König, Johanna ORCID logoORCID: https://orcid.org/0000-0003-2287-7914, Karch, André ORCID logoORCID: https://orcid.org/0000-0003-3014-8543, Leitzmann, Michael ORCID logoORCID: https://orcid.org/0000-0002-0371-2789, Meinke-Franze, Claudia ORCID logoORCID: https://orcid.org/0000-0001-6137-9702, Mikolajczyk, Rafael ORCID logoORCID: https://orcid.org/0000-0003-1271-7204, Nees, Frauke ORCID logoORCID: https://orcid.org/0000-0002-7796-8234, Niendorf, Thoralf ORCID logoORCID: https://orcid.org/0000-0001-7584-6527, Sander, Oliver ORCID logoORCID: https://orcid.org/0000-0001-5196-9370, Schmidt, Carsten Oliver ORCID logoORCID: https://orcid.org/0000-0001-5266-9396, Riedel-Heller, Steffi G. ORCID logoORCID: https://orcid.org/0000-0003-4321-6090, Ritter, Kerstin ORCID logoORCID: https://orcid.org/0000-0001-7115-0020, Peters, Annette ORCID logoORCID: https://orcid.org/0000-0001-6645-0985, Pischon, Tobias ORCID logoORCID: https://orcid.org/0000-0003-1568-767X, Witt, Stephanie ORCID logoORCID: https://orcid.org/0000-0002-1571-1468, Nitsche, Johannes ORCID logoORCID: https://orcid.org/0009-0004-4143-710X, Naamanka, Joonas ORCID logoORCID: https://orcid.org/0000-0003-3092-7416, Volkmer, Sebastian ORCID logoORCID: https://orcid.org/0009-0007-4489-9125, Mai, Antonia ORCID logoORCID: https://orcid.org/0009-0009-9824-7688, Abas, Amrou ORCID logoORCID: https://orcid.org/0009-0008-2928-244X, Li, Xiuzhi, Meyer-Lindenberg, Andreas ORCID logoORCID: https://orcid.org/0000-0001-5619-1123, Gradinger, Tobias ORCID logoORCID: https://orcid.org/0000-0002-8049-2900, Streit, Fabian ORCID logoORCID: https://orcid.org/0000-0003-1080-4339, Braun, Urs ORCID logoORCID: https://orcid.org/0000-0002-6290-3630 and Schwarz, Emanuel ORCID logoORCID: https://orcid.org/0000-0002-0261-5063
Abstract:Structural brain alterations associated with depression and anxiety are subtle, heterogeneous, and difficult to characterize. We applied autoencoder-based normative modeling to contrastively learned structural MRI representations from two large population-based cohorts (German National Cohort, N ≈ 29,000; UK Biobank, N ≈ 25,000) to quantify individual deviations from normative brain structure across symptom dimensions of depression, anxiety, and, for contextualization, alcohol use. Deviation magnitude increased with symptom severity for depressive and anxiety symptoms and was most pronounced in individuals with high alcohol use. Directional analyses revealed shared deviation patterns for depression and anxiety that were largely distinct from alcohol-related deviations, and these patterns generalized across cohorts. These affective-symptom-related patterns implicated distributed regional brain-structural variation. Individual deviation profiles improved classification of symptomatic status beyond demographic covariates, with gains concentrated at higher symptom severity. Together, these findings indicate that affective symptoms are associated with reproducible, dimensional patterns of regional brain-structural deviation that extend beyond normative population variability, supporting transdiagnostic models of internalizing psychopathology. Contact emanuel.schwarz@zi-mannheim.de
Source:medRxiv
Publisher:Cold Spring Harbor Laboratory Press
Article Number:2025.09.26.25336528v2
Date:21 May 2026
Official Publication:https://doi.org/10.1101/2025.09.26.25336528
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