Objectives Psychiatric diagnosis and fractal studies are complex processes that extend beyond clinical evaluation and
require careful methodological considerations in neuroimaging. Over the years, fractals have helped reduce these
complexities in research, but they still cannot grant clinical diagnoses. Thus, the main objective was a systematic
review exploring the potential applications of fractal analysis in characterizing psychiatric conditions through
neuroimaging techniques—including both functional and structural MRI.
Materials and methods A systematic literature review was conducted on PubMed, identifying thirty-nine original
studies that met the inclusion criteria. Areas showing statistical significance (p < 0.05) were reported. These studies
were categorized according to DSM-V classification and examined for the description of psychiatric conditions
through the fractal analysis.
Results The review primarily focuses on young adults with psychiatric conditions compared to control groups.
Schizophrenia and Autism Spectrum Disorder are major areas of investigation, and fractal dimension (FD) is the
primary analysis method used to reflect brain patterns. Studies that calculated whole-brain FD may have
underestimated local abnormalities due to the inclusion of a high percentage of tissue, potentially resulting in
overlooked findings. Notably, abnormalities in the frontal cortex represent a common neurobiological feature across
several psychiatric conditions.
Conclusions The findings from this systematic review shed light on the use of fractal analysis to quantify complex
brain patterns in both psychiatric patients and healthy individuals. However, it is essential to recognize the need for
further research to elucidate a fractal analysis protocol that allows for optimal extraction of psychiatric insights.