Neuroanatomical deficits shared by youth with autism spectrum disorders and psychotic disorders

Autism spectrum disorders (ASD) and early‐onset psychosis (EOP) are neurodevelopmental disorders that share genetic, clinical and cognitive facets; it is unclear if these disorders also share spatially overlapping cortical thickness (CT) and surface area (SA) abnormalities. MRI scans of 30 ASD, 29 patients with early‐onset first‐episode psychosis (EO‐FEP) and 26 typically developing controls (TD) (age range 10–18 years) were analyzed by the FreeSurfer suite to calculate vertex‐wise estimates of CT, SA, and cortical volume. Two publicly available datasets of ASD and EOP (age range 7–18 years and 5–17 years, respectively) were used for replication analysis. ASD and EO‐FEP had spatially overlapping areas of cortical thinning and reduced SA in the bilateral insula (all p ’s < .00002); 37% of all left insular vertices presenting with significant cortical thinning and 20% (left insula) and 61% (right insula) of insular vertices displaying decreased SA overlapped across both disorders. In both disorders, SA deficits contributed more to cortical volume decreases than reductions in CT did. This finding, as well as the novel finding of an absence of spatial overlap (for ASD) or marginal overlap (for EOP) of deficits in CT and SA, was replicated in the two nonoverlapping independent samples. The insula appears to be a region with transdiagnostic vulnerability for deficits in CT and SA. The finding of nonexistent or small spatial overlap between CT and SA deficits in young people with ASD and psychosis may point to the involvement of common aberrant early neurodevelopmental mechanisms in their pathophysiology.