Background/Objectives: Schizophrenia is a severe psychiatric disorder characterized by deficits in perception and advanced cognitive functions. Prior studies have reported abnormal lateralization in cortical morphology and functional connectivity in schizophrenia. However, it remains unclear whether schizophrenia affects hemispheric asymmetry in the hierarchical organization of functional connectome. Methods: Here, we apply a gradient mapping framework to the hemispheric functional connectome to estimate the first three gradients, which characterize unimodal-to-transmodal, visual-to-somatomotor, and somatomotor/default mode-to-multiple demand hierarchy axes. We then assess between-group differences in intra- and inter-hemispheric asymmetries of these three functional gradients. Results: We find that, compared to healthy controls, patients with schizophrenia exhibit significantly altered hemispheric asymmetry in functional gradient across multiple networks, including the dorsal attention, ventral attention, visual, and control networks. Region-level analyses further reveal that patients with schizophrenia show significantly abnormal hemispheric gradient asymmetries in several cortical regions in the dorsal prefrontal gyrus, medial superior frontal gyrus, and somatomotor areas. Lastly, we find that hemispheric asymmetries in functional gradients can differentiate between patients and healthy controls and predict the severity of positive symptoms in schizophrenia. Conclusions: Collectively, these findings suggest that schizophrenia is associated with altered hemispheric asymmetry in functional hierarchy, providing novel perspectives for understanding the atypical brain lateralization in schizophrenia.

Background/Objectives: Cocaine use disorder (CUD) poses a worldwide health challenge, with severe consequences for brain function. However, the phase dynamics underlying CUD and the transitions between CUD and health remain poorly understood. Methods: Here, we used resting-state functional magnetic resonance imaging (fMRI) data from 43 CUD patients and 45 healthy controls (HCT). We performed empirical analysis to identify phase-coherence states and compared their probabilities of occurrence between conditions. To further explore the underlying mechanism, we employed computational modeling to replicate the observed state probabilities for each condition. These generated whole-brain models enabled us to simulate external perturbations and identify optimal brain regions mediating transitions between HCT and CUD. Results: We found that CUD was associated with a reduced occurrence probability of the state dominated by the default mode network (DMN). Perturbing the nucleus accumbens, thalamus, and specific regions within the default mode, limbic and frontoparietal networks drives transitions from HCT to CUD, while perturbing the hippocampus and specific regions within the visual, dorsal attention, and DMN facilitates a return from CUD to HCT. Conclusions: This study revealed altered DMN-related dynamics in CUD from the phase perspective and provides potential regions critical for state transitions. The results contribute to understanding the pathogenesis of CUD and the development of therapeutic stimulation strategies.