Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania
Background: Dysregulated ventral prefrontal-subcortical networks are implicated in bipolar disorder, although how connectivity changes within these networks during the emergence and resolution of affective episodes is unclear. To address this knowledge gap, in this post-hoc study, we investigated lo...
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| Language: | English |
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Elsevier
2025-09-01
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| Series: | Journal of Mood and Anxiety Disorders |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950004425000288 |
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| author | Jennifer E. Siegel-Ramsay Elizabeth Lippard Thomas Blom Wade Webber Cal Adler David E. Fleck Melissa P. DelBello Jorge R.C. Almeida Stephen M. Strakowski |
| author_facet | Jennifer E. Siegel-Ramsay Elizabeth Lippard Thomas Blom Wade Webber Cal Adler David E. Fleck Melissa P. DelBello Jorge R.C. Almeida Stephen M. Strakowski |
| author_sort | Jennifer E. Siegel-Ramsay |
| collection | DOAJ |
| description | Background: Dysregulated ventral prefrontal-subcortical networks are implicated in bipolar disorder, although how connectivity changes within these networks during the emergence and resolution of affective episodes is unclear. To address this knowledge gap, in this post-hoc study, we investigated longitudinal changes in prefrontal-subcortical connectivity during remission from mania in individuals with bipolar I disorder. Methods: We followed 35 individuals with bipolar I disorder through eight weeks of treatment for a manic episode. Using mixed models, we compared changes in ventral prefrontal-subcortical connectivity between individuals who remitted (n = 16, Young Mania Rating Scale/Hamilton Depression Rating Scale < 10 by week eight) and those who did not (n = 19) during emotional distractor conditions of the continuous performance task (CPT-END), a cognitive attentional task with emotional and neutral distractors; at baseline, one and eight weeks of treatment covarying for age and sex. Results: During the eight-week trial, significant group-by-time interactions were found between medial prefrontal cortex and right inferior frontal gyrus pars triangularis. There was also a group-by-time interaction in connectivity between prefrontal cortex and left thalamus, bilateral amygdala, and pregenual anterior cingulate cortex. Conclusion: These results highlight distinct ventral prefrontal-subcortical connectivity patterns characterizing the remitted state in bipolar disorder during tasks requiring focused attention amid emotional distractions. In the context of previous research, remission was associated with more normative connectivity between medial prefrontal and both thalamus and ventrolateral prefrontal cortex. However, while ventral prefrontal–paralimbic/limbic connectivity may show improvement with symptom remission, it may not fully normalize, suggesting residual functional abnormalities despite clinical recovery. |
| format | Article |
| id | doaj-art-bef69a4015664d9b8d317385ddf33852 |
| institution | OA Journals |
| issn | 2950-0044 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Mood and Anxiety Disorders |
| spelling | doaj-art-bef69a4015664d9b8d317385ddf338522025-08-20T02:37:52ZengElsevierJournal of Mood and Anxiety Disorders2950-00442025-09-011110013110.1016/j.xjmad.2025.100131Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar maniaJennifer E. Siegel-Ramsay0Elizabeth Lippard1Thomas Blom2Wade Webber3Cal Adler4David E. Fleck5Melissa P. DelBello6Jorge R.C. Almeida7Stephen M. Strakowski8Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA; Correspondence to: Department of Psychiatry and Behavioral Sciences, Dell Medical School at the University of Austin. 1501 Red River St.,Austin, TX 78712.USA.Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USADepartment of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, OH, USADepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USADepartment of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, OH, USADepartment of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, OH, USADepartment of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, OH, USADepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USADepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA; Department of Psychiatry, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USABackground: Dysregulated ventral prefrontal-subcortical networks are implicated in bipolar disorder, although how connectivity changes within these networks during the emergence and resolution of affective episodes is unclear. To address this knowledge gap, in this post-hoc study, we investigated longitudinal changes in prefrontal-subcortical connectivity during remission from mania in individuals with bipolar I disorder. Methods: We followed 35 individuals with bipolar I disorder through eight weeks of treatment for a manic episode. Using mixed models, we compared changes in ventral prefrontal-subcortical connectivity between individuals who remitted (n = 16, Young Mania Rating Scale/Hamilton Depression Rating Scale < 10 by week eight) and those who did not (n = 19) during emotional distractor conditions of the continuous performance task (CPT-END), a cognitive attentional task with emotional and neutral distractors; at baseline, one and eight weeks of treatment covarying for age and sex. Results: During the eight-week trial, significant group-by-time interactions were found between medial prefrontal cortex and right inferior frontal gyrus pars triangularis. There was also a group-by-time interaction in connectivity between prefrontal cortex and left thalamus, bilateral amygdala, and pregenual anterior cingulate cortex. Conclusion: These results highlight distinct ventral prefrontal-subcortical connectivity patterns characterizing the remitted state in bipolar disorder during tasks requiring focused attention amid emotional distractions. In the context of previous research, remission was associated with more normative connectivity between medial prefrontal and both thalamus and ventrolateral prefrontal cortex. However, while ventral prefrontal–paralimbic/limbic connectivity may show improvement with symptom remission, it may not fully normalize, suggesting residual functional abnormalities despite clinical recovery.http://www.sciencedirect.com/science/article/pii/S2950004425000288Bipolar disorder maniaLongitudinalTreatment responseFunctional connectivityVentral prefrontal cortex |
| spellingShingle | Jennifer E. Siegel-Ramsay Elizabeth Lippard Thomas Blom Wade Webber Cal Adler David E. Fleck Melissa P. DelBello Jorge R.C. Almeida Stephen M. Strakowski Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania Journal of Mood and Anxiety Disorders Bipolar disorder mania Longitudinal Treatment response Functional connectivity Ventral prefrontal cortex |
| title | Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania |
| title_full | Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania |
| title_fullStr | Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania |
| title_full_unstemmed | Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania |
| title_short | Changes in ventral prefrontal-subcortical network connectivity during the course of remission from bipolar mania |
| title_sort | changes in ventral prefrontal subcortical network connectivity during the course of remission from bipolar mania |
| topic | Bipolar disorder mania Longitudinal Treatment response Functional connectivity Ventral prefrontal cortex |
| url | http://www.sciencedirect.com/science/article/pii/S2950004425000288 |
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