Ventral anterior cingulate connectivity distinguished nonpsychotic bipolar illness from psychotic bipolar disorder and schizophrenia.
Bipolar illness is a debilitating neuropsychiatric disorder associated with alterations in the ventral anterior cingulate cortex (vACC), a brain region thought to regulate emotional behavior. Although recent data-driven functional connectivity studies provide evidence consistent with this possibility, the role of vACC in bipolar illness and its pattern of whole brain connectivity remain unknown. Furthermore, no study has established whether vACC exhibits differential whole brain connectivity in bipolar patients with and without co-occurring psychosis and whether this pattern resembles that found in schizophrenia. We conducted a human resting-state functional connectivity investigation focused on the vACC seed in 73 remitted bipolar I disorder patients (33 with psychosis history), 56 demographically matched healthy comparison subjects, and 73 demographically matched patients with chronic schizophrenia. Psychosis history within the bipolar disorder group corresponded with significant between-group connectivity alterations along the dorsal medial prefrontal surface when using the vACC seed. Patients with psychosis history showed reduced connectivity (Cohen's d = -0.69), whereas those without psychosis history showed increased vACC coupling (Cohen's d = 0.8) relative to controls. The vACC connectivity observed in chronic schizophrenia patients was not significantly different from that seen in bipolar patients with psychosis history but was significantly reduced compared with that in bipolar patients without psychosis history. These robust findings reveal complex vACC connectivity alterations in bipolar illness, which suggest differences depending on co-occurrence of lifetime psychosis. The similarities in vACC connectivity patterns in schizophrenia and psychotic bipolar disorder patients may suggest the existence of common mechanisms underlying psychotic symptoms in the two disorders.
alan.anticevic@yale.edu.
Alan
A
Anticevic
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT; University Psychiatric Hospital Vrapce, University of Zagreb, Zagreb, Croatia;
Aleksandar
A
Savic
Department of Psychology, University of Ljubljana, Ljubljana, Slovenia;
Grega
G
Repovs
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT; Interdepartmental Neuroscience Program, Yale University, New Haven, CT;
Genevieve
G
Yang
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT;
D Reese
DR
McKay
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT;
Emma
E
Sprooten
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT;
Emma E
EE
Knowles
Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT;
John H
JH
Krystal
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; NIAAA Center for the Translational Neuroscience of Alcoholism, New Haven, CT; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT; Department of Neurobiology, Yale University, New Haven, CT.
Godfrey D
GD
Pearlson
Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT;
David C
DC
Glahn
D000328:Adult; D001714:Bipolar Disorder / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D059907:Functional Neuroimaging; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011618:Psychotic Disorders / Q000503:physiopathology* / Q000523:psychology; D012559:Schizophrenia / Q000503:physiopathology*; D055815:Young Adult
bipolar illness; connectivity; medial prefrontal cortex; resting-state; schizophrenia