4.7 Article

A graph theory neuroimaging approach to distinguish the depression of bipolar disorder from major depressive disorder in adolescents and young adults

Journal

JOURNAL OF AFFECTIVE DISORDERS
Volume 319, Issue -, Pages 15-26

Publisher

ELSEVIER
DOI: 10.1016/j.jad.2022.09.016

Keywords

Depression; Adolescent; Bipolar disorder; Major depressive disorder; fMRI; Functional connectivity

Funding

  1. National Center for Advancing Translational Science (NCATS) , National Institutes of Health (NIH) [TL1TR001864]
  2. National Institute of Mental Health [R61/UG3MH111929]
  3. American Foundation for Suicide Prevention
  4. International Bipolar Foundation
  5. Boehm Family Foundation
  6. John and Hope Furth Endowment
  7. AIM for Youth Mental Health and Klingenstein Third Generation Foundation
  8. Brain and Behavior Foundation
  9. For the Love of Travis Foundation

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This study aimed to identify functional connectivity differences between depressions of bipolar disorder (BD-Dep) and depressions of major depressive disorder (MDD-Dep). The results showed that there were significant differences in functional connectivity patterns between these two groups, suggesting the potential for early diagnosis and treatment strategies.
Background: Markers to differentiate depressions of bipolar disorder (BD-Dep) from depressions of major depressive disorder (MDD-Dep), and for more targeted treatments, are critically needed to decrease current high rates of misdiagnosis that can lead to ineffective or potentially deleterious treatments. Distinguishing, and specifically treating the depressions, during the adolescent/young adult epoch is especially important to decrease illness progression and improve prognosis, and suicide, as it is the epoch when suicide thoughts and behaviors often emerge. With differences in functional connectivity patterns reported when BD-Dep and MDD-Dep have been studied separately, this study used a graph theory approach aimed to identify functional connectivity differences in their direct comparison. Methods: Functional magnetic resonance imaging whole-brain functional connectivity (Intrinsic Connectivity Distribution, ICD) measures were compared across adolescents/young adults with BD-Dep (n = 28), MDD-Dep (n = 20) and HC (n = 111). Follow-up seed-based connectivity was conducted on regions of significant ICD differences. Relationships with demographic and clinical measures were assessed. Results: Compared to the HC group, both the BD-Dep and MDD-Dep groups exhibited left-sided frontal, insular, and medial temporal ICD increases. The BD-Dep group had additional right-sided ICD increases in frontal, basal ganglia, and fusiform areas. In seed-based analyses, the BD-Dep group exhibited increased interhemispheric functional connectivity between frontal areas not seen in the MDD-Dep group. Limitations: Modest sample size; medications not studied systematically. Conclusions: This study supports bilateral and interhemispheric functional dysconnectivity as features of BD-Dep that may differentiate it from MDD-Dep in adolescents/young adults and serve as a target for early diagnosis and treatment strategies.

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