Differential Lifespan Trajectories of Cerebral Asymmetry in Chinese and Western Populations

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Abstract

Cerebral asymmetry is a core principle of human brain organization, showing dynamic changes across the lifespan and alterations in brain disorders. However, it remains unclear whether lifespan trajectories of asymmetry differ across populations. We compared lifespan structural asymmetry normative charts of 221 cerebral imaging phenotypes from 43,037 Chinese and 56,339 Western participants aged 0–100 years. The two populations showed distinct lifespan asymmetry patterns in 26.2% of the phenotypes. Chinese-minus-Western asymmetry difference curves displayed distinct patterns across brain phenotypes: rightward (45.7%), leftward (26.2%), rightward-to-leftward (11.8%), leftward-to-rightward (10.0%), and unclassified (6.3%). Population-matched normative models outperformed population-unmatched normative models in capturing normal asymmetry variability among healthy individuals and in detecting abnormal asymmetry deviations in patients with Alzheimer’s disease, mild cognitive impairment, schizophrenia, and major depressive disorder. These findings indicate that population mismatch can bias chart-based individual-level asymmetry assessment and underscore the need for population-representative brain asymmetry normative charts.

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