When Randomness Becomes Rigid: Dynamic Connectivity Entropy and Symptom-Linked Network Dysfunction in Schizophrenia

High dimensionality of dynamic functional connectivity (dFNC) data representation complicates clinical interpretation and biomarker discovery. We propose a new complementary analytical framework based on dynamic inter-network connectivity entropy (DICE) and its potential use as a biomarker of mental illness. Our framework shows that DICE features extend beyond patient-control discrimination, revealing distinct pathophysiological signatures and differential associations with symptom dimensions. Using resting-state fMRI data from 311 participants, 160 controls, 151 schizophrenia (SZ) patients, we identified 53 intrinsic networks, computed DICE and derived three families of DICE-based metrics: (i) entropy level and range, (ii) distributional shape and temporal organization, (iii) entropy-state repertoire and occupancy. These measures revealed a multidimensional signature of altered entropy dynamics in SZ: (1) elevated baseline entropy with reduced fluctuation magnitude and reduced entropy acceleration; (2) reduced temporal persistence of entropy excursions and entropy distributions closer to Gaussian; and (3) a narrowed repertoire of entropy states, prolonged time in near-baseline entropy configurations. The DICE-based metrics within the SZ group show different associations with symptom dimensions. Reduced fluctuation magnitude and acceleration were associated with greater PANSS general symptom severity (disturbance of volition and preoccupation). Reduced deviation from Gaussianity was associated with higher PANSS positive severity (delusions and hallucinations). Reduced temporal persistence was associated with multiple PANSS positive, negative, and general symptoms. Reduced entropy-state diversity and prolonged dwell time in near-baseline states were associated with depression and PANSS positive/general severity, respectively. The multidimensional pathophysiology revealed through the different entropy patterns may potentially guide biomarker development and personalized treatments.