Using normative models pre-trained on cross-sectional data to evaluate intra-individual longitudinal changes in neuroimaging data

Longitudinal neuroimaging studies offer valuable insight into brain development, ageing, and disease progression over time. However, prevailing analytical approaches rooted in our understanding of population variation are primarily tailored for cross-sectional studies. To fully leverage the potential of longitudinal neuroimaging, we need methodologies that account for the complex interplay between population variation and individual dynamics. We extend the normative modelling framework, which evaluates an individual’s position relative to population standards, to assess an individual’s longitudinal change compared to the population’s standard dynamics. Using normative models pre-trained on over 58,000 individuals, we introduce a quantitative metric termed ‘ z-diff ’ score, which quantifies a temporal change in individuals compared to a population standard. This approach offers advantages in flexibility in dataset size and ease of implementation. We applied this framework to a longitudinal dataset of 98 patients with early-stage schizophrenia who underwent MRI examinations shortly after diagnosis and 1 year later. Compared to cross-sectional analyses, showing global thinning of grey matter at the first visit, our method revealed a significant normalisation of grey matter thickness in the frontal lobe over time—an effect undetected by traditional longitudinal methods. Overall, our framework presents a flexible and effective methodology for analysing longitudinal neuroimaging data, providing insights into the progression of a disease that would otherwise be missed when using more traditional approaches.