TABLE 1.
Summary of the large‐scale functional brain networks altered in bipolar disorder according to ROI‐based studies
| Study (1st author) | Imaging modality | BD type | N (BD/HC) | Functional network | Altered direction | Clinical implications | Seeds of significant functional connectivity |
|---|---|---|---|---|---|---|---|
| Anand et al. (2009) | rs‐fMRI | BD | 11/15 | SAN‐LIM | Decrease | Greater severity of mood dysregulation | AMYG, DMTHAL, perigenual ACC, pallidostriatum |
| Anticevic et al. (2013) | rs‐fMRI | BD I | 68/51 |
DMN, CEN‐LIM |
Decrease, Increase |
Greater severity of lifetime psychotic symptoms | AMYG, DLPFC, mPFC |
| Baker et al. (2014) | rs‐fMRI | BD | 40/100 | CEN | Decrease | Disrupted ability to distinguish between internal and external oriented processing | DLPFC, lateral parietal cortex, postero mPFC, posterior temporal cortex |
| Chai et al. (2011) | rs‐fMRI | BD | 14/15 |
CEN‐DMN, SAN‐DMN |
Decrease, Increase |
Overly heightened attention that leads to disturbed responses to salient stimuli | Anterior INS, DLPFC, mPFC, VLPFC |
| Chen et al. (2019) | rs‐fMRI | BD II | 90/100 | DMN‐CBL | Decrease | Neurobiological feature of BD II depressed state | Crus I, Crus II, MFG, mPFC, precuneus |
| Dell'Osso et al. (2015) | task‐fMRI | BD I, II | 28/27 | CEN | Increase | Brain functional abnormality occurs prior to emergence of cognitive deficit in BD | DLPFC |
| Dvorak et al. (2019) a | rs‐fMRI | BDE | 20/30 | LIM | Decrease | Distinct emotional information processing than individuals with MDD | Caudate, fusiform gyri, hippocampus, MFG, MTG, olfactory cortex, putamen |
| Ellard et al. (2018) | rs‐fMRI | BD | 24/39 | SAN‐CEN, SAN | Decrease | Greater impairment in perceived emotion and reward sensitivity | INS, IPL |
| Ellard et al. (2019) | task‐fMRI | BD I | 39/36 |
DMN, CEN, SAN‐CEN |
Decrease, Increase |
Impaired performance accuracy in cognitive task | Anterior INS, DLPFC, DMPFC, IPL, VLPFC |
| Favre et al. (2014) | rs‐fMRI | BDE | 20/20 |
CEN‐DMN DMN‐LIM |
Decrease, Increase |
Longer disease duration | AMYG, DLPFC, mPFC |
| Gong et al. (2019) | rs‐fMRI | BD II | 96/100 | DMN, SAN | Decrease | Underlies depressive state of BD II | ITG, mPFC, PCC, precuneus, subgenual ACC |
| He et al. (2018) | rs‐fMRI | BD I, II | 32/43 | DMN‐CBL, CEN‐CBL | Decrease | Disrupted self‐referential and affective processing | Cerebellar vermis IV/V, cerebellar lobule IX, Crus I, DLPFC, precuneus, subgenual ACC |
| He et al. (2019) | rs‐fMRI | BD | 25/34 | CEN‐LIM | Increase | Longer average duration per episode | DLPFC, precuneus, striatum |
| Karcher et al. (2019) | rs‐fMRI | BD | 40/60 | SAN | Decrease | Impaired information integration | – |
| Li, Tang, et al. (2018) | rs‐fMRI | BD | 46/66 | SAN‐DMN, SAN‐LIM | Increase | Underlies shared cognitive and emotional dysfunction as in schizophrenia | Anterior INS, dorsal INS, fontal pole, MFG, perigenual ACC, THAL |
| Liu et al. (2019) | rs‐fMRI | BD | 23/24 | DMN, DMN‐LIM | Decrease | Greater severity of depression (HDRS) | AMYG, hippocampus, inferior occipital gyrus, MTG, PCC, precuneus, THAL, SFG, STG |
| Luo et al. (2018) | rs‐fMRI | BD II | 94/100 | DMN‐CBL, CEN‐CBL | Decrease | Disruption in cognition and self‐referential mentality | ACC, crus Ia/Ib, DLPFC, mPFC, MTG, ITG |
| Magioncalda et al. (2015) | rs‐fMRI | BD | 40/40 | DMN, SAN | Decrease | Greater severity of depression (HDRS), mania (YMRS), and cognitive deficit | ITG, PCC, supragenual ACC |
| Mamah et al. (2013) | rs‐fMRI | BD | 35/33 | SAN, SAN‐CBL | Decrease | Greater disorganization symptoms | – |
| Marchand et al. (2014) | task‐fMRI | BD II | 19/18 | DMN | Increase | Neurobiological trait pathology of BD | Dorsolateral SFG, medial SFG, SFG |
| Oertel‐Knöchel et al. (2015) | rs‐fMRI | BD | 21/21 | SAN‐DMN | Increase | Impaired episodic memory | MFG, MTG, SFG, STG, ACC |
| Pang et al. (2018) | rs‐fMRI | BD | 30/30 | SAN, SAN‐DMN | Decrease | Greater severity of depression (HDRS) | Dorsal anterior INS, ventral anterior INS, VLPFC |
| Pompei et al. (2011) | task‐fMRI | BDE | 39/48 | SAN‐CEN | Decrease | Dysfunctional integration of networks | DLPFC, INS, ventral ACC, VLPFC |
| Radaelli et al. (2015) | task‐fMRI | BD I | 52/40 | CEN‐LIM | Decrease | Abnormal modulation of emotion | ACC, AMYG, DLPFC |
| Rey et al. (2016) | rs‐fMRI | BD, BDE | 27/27 | SAN‐DMN, DMN‐LIM | Increase | Disrupted mood, increased rumination | AMYG, PCC, subgenual ACC, VLPFC |
| Roberts et al. (2017) a | rs‐fMRI | BD I, II | 49/80 | CEN‐DMN | Decrease | Intrusive emotional rumination | ITG, putamen, STG, VLPFC |
| Rodríguez‐Cano et al. (2017) | task‐fMRI | BD I | 26/26 |
DMN, CEN, CBL |
Increase, Decrease |
Dysregulation in response to sensory and emotional stimuli | Cerebellum, DLPFC, DMPFC, mPFC, precuneus, |
| Sheffield et al. (2017) | rs‐fMRI | BD | 129/201 | SAN | Decrease | Disrupted integration of information | – |
| Townsend et al. (2013) | task‐fMRI | BD I | 30/26 | SAN‐DMN, CEN‐LIM | Decrease | Disrupted ability to relapse into acute mood state | ACC, DLPFC, MFG, PCC, VLPFC |
| Wang, Zhong, et al., 2018 | rs‐fMRI | BD II | 25/25 | DMN‐CBL | Decrease | Pathology of the state of remission in BD | Cerebellar lobule VIIb/VIIIa, hippocampus, IPL, PCC, paracentral lobule, precuneus, putamen, STG |
The altered functional connectivity of large‐scale functional brain networks in bipolar disorder as reported in the ROI‐based studies reviewed. The name of the large‐scale functional brain network was determined either by the authors themselves within the study and/or based on the major brain regions that were used as a priori seeds. The direction of alteration for each study is in reference to the respective healthy control group. Functional connectivity between brain regions were reported under the term “decrease” for both positive and negative connectivities, including cases where the polarity of the functional connectivity was reversed.
Abbreviations: ACC, anterior cingulate cortex; AMYG, amygdala; BD, bipolar disorder (type unspecified); BD I, bipolar 1 disorder; BD II, bipolar 2 disorder; BDE, euthymic bipolar disorder; CBL, cerebellar network; CEN, central executive network; DLPFC, dorsolateral prefrontal cortex; DMN, default mode network; DMPFC, dorsomedial prefrontal cortex; DMTHAL, dorsomedial thalamus; EMN, episodic memory network; HC, healthy control; HDRS, Hamilton Depression Rating Scale; INS, insula; IPL, inferior parietal lobule; ITG, inferior temporal gyrus; LIM, limbic network; MDD, major depressive disorder; MFG, middle frontal gyrus; mPFC, medial prefrontal cortex; MTG, middle temporal gyrus; N, sample size; PCC, posterior cingulate cortex; PFC, prefrontal cortex; ROI, region‐of‐interest; rs‐fMRI, resting‐state functional magnetic resonance imaging; SAN, salience network; SFG, superior frontal gyrus; STG, superior temporal gyrus; task‐fMRI, task‐based functional magnetic resonance imaging; THAL, thalamus; VLPFC, ventrolateral prefrontal cortex; VMPFC, ventromedial PFC; YMRS, Young Mania Rating Scale.
Network‐based statistics studies that compared the between‐group differences in functional connectivity strength of an a priori region with other regional connections and networks.