Development of the craniofacies occurs in embryological intimacy with development of the brain and both show normal left-right asymmetries. While facial dysmorphology occurs to excess in psychotic illness, facial asymmetry has yet to be investigated as a putative index of brain asymmetry. Ninety-three subjects (49 controls, 22 schizophrenia, 22 bipolar disorder) received 3D laser surface imaging of the face. On geometric morphometric analysis with (x, y, z) visualisations of statistical models for facial asymmetries, in controls the upper face and periorbital region, which share embryological intimacy with the forebrain, showed marked asymmetries. Their geometry included: along the x-axis, rightward asymmetry in its dorsal-medial aspects and leftward asymmetry in its ventral-lateral aspects; along the z-axis, anterior protrusion in its right ventral-lateral aspect. In both schizophrenia and bipolar disorder these normal facial asymmetries were diminished, with residual retention of asymmetries in bipolar disorder. This geometry of normal facial asymmetries shows commonalities with that of normal frontal lobe asymmetries. These findings indicate a trans-diagnostic process that involves loss of facial asymmetries in both schizophrenia and bipolar disorder. Embryologically, they implicate loss of face-brain asymmetries across gestational weeks 7-14 in processes that involve genes previously associated with risk for schizophrenia.

Centre for Image Processing and Analysis Dublin City University Dublin Ireland

Department of Information and Communication Technologies Pompeu Fabra University Barcelona Spain

School of Mathematics and Statistics University of Glasgow Glasgow UK; Institute of Mathematics and Statistics Masaryk University Brno Czech Republic

School of Pharmacy and Biomolecular Sciences RCSI University of Medicine and Health Sciences Dublin Ireland; Jiangsu Key Laboratory of Translational Research and Therapy for Neuropsychiatric Disorders Department of Pharmacology College of Pharmaceutical Sciences Soochow University Suzhou China

St John of God Hospital Stillorgan Co Dublin Ireland; Department of Psychiatry Trinity Centre for Health Sciences Tallaght University Hospital Dublin Ireland

St John of God Hospital Stillorgan Co Dublin Ireland; School of Medicine and Medical Sciences University College Dublin Dublin Ireland

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