Connectomics: a new paradigm for understanding brain disease

In recent years, pathophysiological models of brain disorders have shifted from an emphasis on understanding pathology in specific brain regions to characterizing disturbances of interconnected neural systems. This shift has paralleled rapid advances in connectomics, a field concerned with comprehensively mapping the neural elements and inter-connections that constitute the brain. Magnetic resonance imaging (MRI) has played a central role in these efforts, as it allows relatively cost-effective in vivo assessment of the macro-scale architecture of brain network connectivity. In this paper, we provide a brief introduction to some of the basic concepts in the field and review how recent developments in imaging connectomics are yielding new insights into brain disease, with a particular focus on Alzheimer's disease and schizophrenia. Specifically, we consider how research into circuit-level, connectome-wide and topological changes is stimulating the development of new aetiopathological theories and biomarkers with potential for clinical translation. The findings highlight the advantage of conceptualizing brain disease as a result of disturbances in an interconnected complex system, rather than discrete pathology in isolated sub-sets of brain regions.