Charting brain morphology in international healthy and neurological populations

Quantifying individual deviations in brain morphology from normative references is useful for understanding neurodiversity and facilitating personalized management of brain health. Here we report Chinese brain normative references using morphological imaging scans of 24,061 healthy volunteers from 105 sites, revealing later peak ages of lifespan neurodevelopmental milestones (1.2–8.9 years) than European/North American populations. We model individual brain deviation scores in 3,932 individuals with different neurological disorders from population references to evaluate three key aspects of brain health assessment using machine learning approaches: estimating disease propensity, predicting cognitive and physical outcomes and assessing treatment effects with distinct disability progression. The norm-deviation scores outperformed raw structural measures in these evaluations. Chinese-specific normative brain references may foster personalized diagnosis and prognosis in neurological diseases, enabling clinically applicable assessments of brain health.