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After preprocessing, we input the z-scores into SuStaIn. This page highlights three key points:

  1. Main SuStaIn results — the optimal number of subtypes and the ordering of lobes
  2. Baseline differences — covariates and NIH Toolbox measures compared between the two subtypes
  3. Follow-up trajectories — longitudinal patterns of BMI and CBCL across subtypes </aside>

1. Main Results


The plots below illustrate the reconstructed progression sequences of regional brain changes at the lobe level, derived using the SuStaIn model.

On the left, case participants (i.e., children exposed to GDM) are stratified into two distinct subtypes, each characterized by a different temporal ordering of affected lobes. The optimal number of subtypes was determined using cross-validation and information criteria.

On the right, the ordering derived from healthy controls is shown for comparison. Together, these visualizations highlight both the heterogeneity among exposed individuals and their divergence from the control trajectory


Subtype 1 ( n = 372, 65%): insula → occipital_lobe → parietal_lobe → temporal_lobe → frontal_lobe → cingulate

Subtype 2 ( n = 202, 35%): frontal_lobe → parietal_lobe → temporal_lobe → occipital_lobe → cingulate → insula

HC ( n = 3557): occipital_lobe → parietal_lobe → frontal_lobe → temporal_lobe → insula → cingulate

Ordering of Subtype 1 & Subtype 2. path: MRIthickness/sim_lobe_cortical_0917/sim

Ordering of Subtype 1 & Subtype 2. path: MRIthickness/sim_lobe_cortical_0917/sim

Ordering of HC. path:MRIthickness/sim_lobe_cortical_hc

Ordering of HC. path:MRIthickness/sim_lobe_cortical_hc

The pairwise similarities between the ordering, none of the pairs are significantly associated.

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2. Baseline Distribution


Covariates

The only baseline covariate that differed between the two subtypes was gestational age : subtype 1, 38.4 (2.9); subtype 2, 38.9 (2.3).

The total is larger than subtype 1 + subtype 2 bc we hide the HCs distribution.

The total is larger than subtype 1 + subtype 2 bc we hide the HCs distribution.

image.png