The variegation of human brain vulnerability to rare genetic disorders and convergence with behaviorally defined disorders

Diverse gene dosage disorders (GDDs) increase risk for psychiatric impairment, but characterization of GDD effects on the human brain has so far been piecemeal and lacked simultaneous analysis of multiple brain features across different GDDs. Here, through multimodal neuroimaging of 3 aneuploidy syndromes (XXY, XYY, trisomy 21), we reveal considerable diversity in cortical changes across GDDs and imaging-derived phenotypes (IDPs). This variegation of IDP change underlines the limitations of studying GDD effects unimodally. Integration across all IDP maps reveals highly distinct architectures of cortical change in each GDD, along with partial coalescence onto a common spatial axis of cortical vulnerability. This common axis shows strong alignment with shared cortical changes in behaviorally defined psychiatric disorders, and is enriched for specific molecular and cellular signatures - offering a high-priority target for future translational research.