More than a billion people worldwide live with one or more mental health conditions that affect their mood, thinking, and behavior. These conditions vary greatly in severity but almost always impact daily functioning. A better understanding of the biological basis of these disorders is crucial for improving diagnostics and personalizing treatments.
A recent study by researchers at Copenhagen University Hospital, in collaboration with the University of Copenhagen, shows that routinely collected MRI scans from clinical practice can provide valuable insights. The results, published in Molecular Psychiatry, confirm that various mental disorders are associated with similar structural changes in the brain.
MRI scans as a data source
Until now, brain research in psychiatry has often been based on relatively small, carefully selected study groups. While initiatives such as the international ENIGMA Consortium have pooled these datasets, they remained dependent on aggregated data from studies with varying methods and patient groups.
The Danish researchers took a different approach: they analyzed thousands of MRI scans performed in daily clinical practice. In Denmark, these scans are linked to electronic health records, creating a unique combination of imaging and clinical data.
Although this “real-world” data is often less standardized than research data, it has proven suitable for detecting relevant brain differences. This opens the door to larger-scale research that is closer to clinical reality.
Analysis of thousands of patients
The researchers analyzed all brain scans performed in Denmark in 2019. By linking these to medical records, they were able to identify patients with a recent diagnosis of a mental health condition, as well as a control group without psychiatric or neurological conditions.
In total, data from more than 23,000 patients were reviewed, of whom approximately 4,800 ultimately met the inclusion criteria. The data was processed in a pseudonymized manner to ensure patient privacy. Using advanced analytical tools, the researchers were able to measure, among other things, the thickness of the cerebral cortex and the volumes of various brain regions. Factors such as age, gender, and the MRI scanners used were taken into account.
Brain abnormalities confirmed
The study confirms earlier findings from decades of brain research. On average, patients with severe mental disorders exhibit:
- a smaller thalamus
- a smaller amygdala
- enlarged cerebral ventricles (fluid-filled cavities)
- a thinner cerebral cortex
What is striking is that these patterns are now also visible in routinely collected clinical data. This underscores that MRI scans from daily clinical practice are useful for scientific research, provided they are analyzed on a large scale. In addition, linking this data with patient records offers new possibilities. For example, researchers can investigate how medication use, comorbidity, or disease stage correlate with changes in the brain, questions that are difficult to answer in traditional studies.
Foundation for new applications
The combination of large-scale MRI data and clinical information can form the foundation for new applications, such as AI-driven diagnostics. By recognizing patterns in brain scans, algorithms could help predict or classify mental disorders in the future.
More importantly, this approach can contribute to “precision psychiatry”: the classification of patients into biologically grounded subgroups. This enables more targeted treatments and can ultimately lead to better outcomes for patients. According to the researchers, clinical data may even be more valuable than traditional research data, as it provides a more realistic picture of the patient population in daily practice.
Broader research
Although the current study is limited to data from a single year, Denmark has a much larger historical database. Future research will focus on longitudinal analyses, in which patients are followed over a longer period of time.
This could provide insight into how the brain changes before, during, and after the onset of a mental disorder. It may also be possible to detect early signs, even before symptoms fully manifest. Additionally, the researchers aim to expand their analyses to other disorders, such as bipolar disorder and ADHD, which were underrepresented in this study.
The ambition is clear: to bridge the gap between clinical practice and neurobiological research. This brings us ever closer to a time when the diagnosis and treatment of mental disorders will be based not only on symptoms, but also on measurable changes in the brain.
