Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study

Abstract Bipolar disorder (BD) and unipolar depression (UD) are defined as distinct diagnostic categories. However, due to some common clinical and pathophysiological features, it is a clinical challenge to distinguish them, especially in the early stages of BD. This study aimed to explore the commo...

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Main Authors: Hao Sun, Rui Yan, Zhilu Chen, Xiaoqin Wang, Yi Xia, Lingling Hua, Na Shen, Yinghong Huang, Qiudong Xia, Zhijian Yao, Qing Lu
Format: Article
Language:English
Published: Nature Publishing Group 2025-02-01
Series:Translational Psychiatry
Online Access:https://doi.org/10.1038/s41398-025-03282-x
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author Hao Sun
Rui Yan
Zhilu Chen
Xiaoqin Wang
Yi Xia
Lingling Hua
Na Shen
Yinghong Huang
Qiudong Xia
Zhijian Yao
Qing Lu
author_facet Hao Sun
Rui Yan
Zhilu Chen
Xiaoqin Wang
Yi Xia
Lingling Hua
Na Shen
Yinghong Huang
Qiudong Xia
Zhijian Yao
Qing Lu
author_sort Hao Sun
collection DOAJ
description Abstract Bipolar disorder (BD) and unipolar depression (UD) are defined as distinct diagnostic categories. However, due to some common clinical and pathophysiological features, it is a clinical challenge to distinguish them, especially in the early stages of BD. This study aimed to explore the common and disease-specific connectivity patterns in BD and UD. This study was constructed over 181 BD, 265 UD and 204 healthy controls. In addition, an independent group of 90 patients initially diagnosed with major depressive disorder at the baseline and then transferred to BD with the episodes of mania/hypomania during follow-up, was identified as initial depressive episode BD (IDE-BD). All participants completed resting-state functional magnetic resonance imaging (R-fMRI) at recruitment. Both network-based analysis and graph theory analysis were applied. Both BD and UD showed decreased functional connectivity (FC) in the whole brain network. The shared aberrant network across groups of patients with depressive episode (BD, IDE-BD and UD) mainly involves the visual network (VN), somatomotor networks (SMN) and default mode network (DMN). Analysis of the topological properties over the three networks showed that decreased clustering coefficient was found in BD, IDE-BD and UD, however, decreased shortest path length and increased global efficiency were only found in BD and IDE-BD but not in UD. The study indicate that VN, SMN, and DMN, which involve stimuli reception and abstraction, emotion processing, and guiding external movements, are common abnormalities in affective disorders. The network separation dysfunction in these networks is shared by BD and UD, however, the network integration dysfunction is specific to BD. The aberrant network integration functions in BD and IDE-BD might be valuable diagnostic biomarkers.
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spelling doaj-art-b63f120fbda74fc1a7203c3ca1f6d7a42025-08-20T03:10:52ZengNature Publishing GroupTranslational Psychiatry2158-31882025-02-011511810.1038/s41398-025-03282-xCommon and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic studyHao Sun0Rui Yan1Zhilu Chen2Xiaoqin Wang3Yi Xia4Lingling Hua5Na Shen6Yinghong Huang7Qiudong Xia8Zhijian Yao9Qing Lu10Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityNanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical UniversityNanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversitySchool of Biological Sciences and Medical Engineering, Southeast UniversityAbstract Bipolar disorder (BD) and unipolar depression (UD) are defined as distinct diagnostic categories. However, due to some common clinical and pathophysiological features, it is a clinical challenge to distinguish them, especially in the early stages of BD. This study aimed to explore the common and disease-specific connectivity patterns in BD and UD. This study was constructed over 181 BD, 265 UD and 204 healthy controls. In addition, an independent group of 90 patients initially diagnosed with major depressive disorder at the baseline and then transferred to BD with the episodes of mania/hypomania during follow-up, was identified as initial depressive episode BD (IDE-BD). All participants completed resting-state functional magnetic resonance imaging (R-fMRI) at recruitment. Both network-based analysis and graph theory analysis were applied. Both BD and UD showed decreased functional connectivity (FC) in the whole brain network. The shared aberrant network across groups of patients with depressive episode (BD, IDE-BD and UD) mainly involves the visual network (VN), somatomotor networks (SMN) and default mode network (DMN). Analysis of the topological properties over the three networks showed that decreased clustering coefficient was found in BD, IDE-BD and UD, however, decreased shortest path length and increased global efficiency were only found in BD and IDE-BD but not in UD. The study indicate that VN, SMN, and DMN, which involve stimuli reception and abstraction, emotion processing, and guiding external movements, are common abnormalities in affective disorders. The network separation dysfunction in these networks is shared by BD and UD, however, the network integration dysfunction is specific to BD. The aberrant network integration functions in BD and IDE-BD might be valuable diagnostic biomarkers.https://doi.org/10.1038/s41398-025-03282-x
spellingShingle Hao Sun
Rui Yan
Zhilu Chen
Xiaoqin Wang
Yi Xia
Lingling Hua
Na Shen
Yinghong Huang
Qiudong Xia
Zhijian Yao
Qing Lu
Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study
Translational Psychiatry
title Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study
title_full Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study
title_fullStr Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study
title_full_unstemmed Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study
title_short Common and disease-specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes: a transdiagnostic study
title_sort common and disease specific patterns of functional connectivity and topology alterations across unipolar and bipolar disorder during depressive episodes a transdiagnostic study
url https://doi.org/10.1038/s41398-025-03282-x
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