Functional dysconnectivity of anterior cingulate subregions in schizophrenia and psychotic and nonpsychotic bipolar disorder

Aberrant resting-state functional connectivity (FC) of anterior cingulate cortex (ACC) has been implicated in the pathophysiology of schizophrenia and bipolar disorder (BP). This study investigated the subregional FC of ACC across schizophrenia and psychotic (PBP) and nonpsychotic BP (NPBP) and the relationship between brain functional alterations and clinical manifestations. A total of 174 first-episode medication-naive patients with schizophrenia (FES), 80 patients with PBP, 77 patients with NPBP and 173 demographically matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Brain-wide FC of ACC subregions was computed for each individual, and compared between the groups. General intelligence was evaluated using the short version of the Wechsler Adult Intelligence Scale. Relationships between FC and various clinical and cognitive variables were estimated using the skipped correlation. The FES, PBP and NPBP groups showed differing connectivity patterns in the left caudal, dorsal and perigenual ACC. Transdiagnostic dysconnectivity was found in the subregional ACC associated with cortical, limbic, striatal and cerebellar regions. Disorder -specific dysconnectivity in FES was identified between the left perigenual ACC and bilateral orbitofrontal cor-tex, and the left caudal ACC coupling with the default mode network (DMN) and visual processing region was correlated with psychotic symptoms. In the PBP group, FC between the left dorsal ACC and the right caudate was correlated with psychotic symptoms, and FC connected with the DMN was associated with affective symptoms. The current findings confirmed that subregional ACC dysconnectivity could be a key transdiagnostic feature and associated with differing clinical symptomology across schizophrenia and PBP.

Automated summary

This study investigated the aberrant resting-state functional connectivity of anterior cingulate cortex (ACC) in schizophrenia and bipolar disorder (BP), and its relationship with clinical manifestations. The results showed that different subregions of ACC exhibited varying connectivity patterns in patients with schizophrenia, psychotic BP, and nonpsychotic BP. Transdiagnostic dysconnectivity was found in ACC subregions associated with cortical, limbic, striatal, and cerebellar regions. The study also identified disorder-specific dysconnectivity in patients with schizophrenia and psychotic BP, which were correlated with specific clinical symptoms.