The following is a summary of “Transdiagnostic types of formal thought disorder and their association with gray matter brain structure: a model-based cluster analytic approach,” published in the April 2025 issue of Molecular Psychiatry by Stein et al. 

Researchers conducted a retrospective study to identify data-driven subtypes of formal thought disorder (FTD) in psychotic and affective disorders. Clustering revealed latent psychopathological structures underlying FTD symptoms. 

They conducted latent profile analysis (LPA) of FTD symptoms in 1,032 patients with schizophrenia-spectrum-disorders (n=107), major depressive (n=800), and bipolar disorder (n=125). Clusters were compared for cognition and psychopathology, and T1-weighted MRI data were analyzed with CAT12 for gray matter volume (GMV) and cortical surface features. Robustness analyses used an age- and sex-matched subsample (n=321) with equal diagnosis groups (n=107). 

The results showed 4 transdiagnostic clusters: minimal FTD, poverty, inhibition, and severe FTD, stable across diagnoses and in the matched subsample. Severe FTD showed GMV reductions in the right superior and middle frontal gyri compared to minimal FTD. Inhibition showed GMV reduction in the right inferior and middle temporal gyri and fusiform gyrus compared to minimal and severe FTD. Sulcal depth was reduced around the left insula, superior temporal sulcus, and temporal pole in the poverty cluster, and in the bilateral insula in the severe cluster, both compared to inhibition. No results were found for cortical thickness, gyrification, and complexity. Findings replicated in the matched subsample. 

Investigators unraveled the clinical heterogeneity of FTD across affective and psychotic disorders. They found associations between FTD clusters and language-related brain structures involved in thought and language impairment. 

Source: nature.com/articles/s41380-025-03009-w