Distance- and Hierarchy-Dependent Functional Dysconnectivity in Schizophrenia and Its Association with Cortical Microstructure.

Background: Schizophrenia is associated with widespread functional dysconnectivity, but the spatial scale and structural correlates of these alterations remain unclear. Short-range connectivity, in particular, has received limited attention due to methodological constraints, despite its relevance to local microcircuit dysfunction. Methods: We applied a vertex-wise, distance-dependent analysis of functional connectivity strength (FCS) to resting-state fMRI data from 86 schizophrenia patients and 99 healthy controls across two datasets. FCS was partitioned by geodesic distance on the cortical surface and analyzed by cortical hierarchy. We also assessed two proxies of intracortical microstructure: T1w/T2w ratio and a novel signal-detection-based measure of individualized data-driven functional connectivity density (idFCD). Results: Schizophrenia patients exhibited reductions in short-range FCS within the dorsal primary somatosensory cortex. These functional alterations colocalized with abnormalities in both microstructural proxies and were not evident in global FCS analysis. In contrast, longer-range FCS was increased in transmodal regions, particularly the precuneus, without associated microstructural differences. Hierarchical analysis confirmed this dissociation, with structure-function disruption in primary networks and increased relative FCS in transmodal regions without microstructural association. Conclusions: Our findings support two distinct patterns of cortical dysconnectivity in schizophrenia: short-range reductions in primary sensory areas that colocalize with microstructural abnormalities, and longer-range increases in transmodal regions that appear structurally decoupled at the local level. By integrating distance-dependent functional measures with independent proxies of intracortical microstructure, this study highlights the underappreciated role of short-range connectivity disruptions in primary areas and provides a complementary framework to conventional approaches based on regional or global analyses and diffusion-weighted imaging.