Are schizophrenia, autistic, and obsessive spectrum disorders dissociable on the basis of neuroimaging morphological findings?: A voxel-based meta-analysis.
One brain-change pattern spans autism, schizophrenia, and OCD, so treat the symptom, not the diagnosis box.
01Research in Context
What this study did
Cauda et al. (2017) pooled brain scans from people with autism, schizophrenia, or obsessive-compulsive disorder. They used voxel-based meta-analysis to see if each illness has its own brain signature.
What they found
The three disorders did not show separate brain change maps. Instead, they shared clusters of gray- and white-matter differences. One pattern fits all three labels.
How this fits with other research
Seiverling et al. (2012) and Duerden et al. (2012) earlier reported distinct ASD-only imaging findings. Franco’s wider lens shows those "unique" spots vanish when schizophrenia and OCD are added to the mix.
Osipowicz et al. (2015) found lifelong gray-matter loss in ASD. Franco’s data say similar loss also shows up in schizophrenia and OCD, so the loss is not autism-specific.
Azim et al. (2025) now urge domain-based tests instead of diagnosis names. Franco’s shared brain findings give the biological reason: the brain does not respect DSM borders.
Why it matters
Stop hunting for an "autism brain picture." Shared alterations mean you should assess skills and barriers across clients no matter their label. A social-attention deficit in OCD may respond to the same ABA tactics you use for ASD. Focus on behavior, not the diagnosis name.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Take your client with dual ASD-OCD labels and run the same social-skills baseline you use for ASD-only kids.
02At a glance
03Original abstract
Schizophrenia spectrum disorder (SCZD), autism spectrum disorder (ASD), and obsessive-compulsive spectrum disorder (OCSD) are considered as three separate psychiatric conditions with, supposedly, different brain alterations patterns. From a neuroimaging perspective, this meta-analytic study aimed to address whether this nosographical differentiation is actually supported by different brain patterns of gray matter (GM) or white matter (WM) morphological alterations. We explored two possibilities: (a) to find out whether GM alterations are specific for SCZD, ASD, and OCSD; and (b) to associate the identified brain alteration patterns with cognitive dysfunctions by means of an analysis of lesion decoding. Our analysis reveals that these psychiatric spectra do not present clear distinctive patterns of alterations; rather, they all tend to be distributed in two alteration clusters. Cluster 1, which is more specific for SCZD, includes the anterior insular, anterior cingulate cortex, ventromedial prefrontal cortex, and frontopolar areas, which are parts of the cognitive control system. Cluster 2, which is more specific for OCSD, presents occipital, temporal, and parietal alteration patterns with the involvement of sensorimotor, premotor, visual, and lingual areas, thus forming a network that is more associated with the auditory-visual, auditory, premotor visual somatic functions. In turn, ASD appears to be uniformly distributed in the two clusters. The three spectra share a significant set of alterations. Our new approach promises to provide insight into the understanding of psychiatric conditions under the aspect of a common neurobiological substrate, possibly related to neuroinflammation during brain development. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1079-1095. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1759