Functional Reorganization across Four Episodes in Bipolar Disorder
Bibliographic record
Abstract
Abstract Bipolar disorder (BD) is a heterogeneous psychiatric condition encompassing various episode states, including manic (BipM), depressive (BipD), mixed (mBD), and remission (rBD). Cumulative evidence has revealed that few BD episodes exhibit brain functional connectome changes; however, these findings remain fragmentary, and a systematic understanding of these functional alterations among all episodes is still lacking. Here, we firstly aimed to investigate how these episodes are differentially represented along the sensory-association axis, which constitutes the primary functional organization spectrum of the human cortex. We found expansion in sensory regions with compression in association regions in BipM, BipD and rBD as well as expansion in visual regions and prefrontal regions, compression motor regions, and precuneus regions for mBD compared to healthy controls. By examining outward and inward activity propagation in association regions, we observed less frequent flows in BipM and BipD, clarifying that association may be dominant in functional reorganization. mBD showed more frequent inward flows than other episodes in both sensory and associations, emphasizing information exchange between these two anchors. By evaluating the network integration and segregation, we observed an increase in functional integration alongside a decrease in functional segregation for unipolar episodes and the greatest functional integration for mBD. Furthermore, clinical relevance analysis suggests that emotional changes were mainly related to association functional reorganization, which may be used as specific and sensitive biomarkers to detect mood changes in different episodes. Finally, the episode representations were spatially correlated with distribution of serotonin transporter, gamma-aminobutyric acid type A receptor, Alpha-4-Beta-4 nicotinic acetylcholine receptor, layer 4 and layer 5 excitatory neurons. This study demonstrates functional reorganization as a biomarker as well as a uniform and simplified framework of neural phenotype to quantify mental abnormality of different BD episodes systematically.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".