Common and Specific Intrinsic Functional NetworkRelated to Episode Dynamics during Treatment in Bipolar Spectrum

A significant challenge in bipolar disorder (BD) is to understand the neural substrates of emotional fluctuations (i.e., episode phases) along the spectrum including manic (BipM), depressive (BipD), and remission states (rBD). Here, We constructed intrinsic functional connectome for 117 subjects with BD (BipM: 38, BipD: 42, and rBD: 37) and 35 healthy controls, then associated connectivities with emotional fluctuations to identify the common and specific patterns, and finally probed their biological underpinnings. We uncovered the common altered pattern in the salience-attention network and the specific pattern in the default mode-salience network specific for BipM and sensory-prefrontal network specific for BipD and rBD. These pathological patterns can accurately delineate the various episodes episodes types of bipolar disorder and forecast the corresponding clinical symptoms associated with each episodes type. Both common and specific patterns exhibited significant genetic stability and centered regions were enriched in multiple receptors such as MOR, NMDA, and H3 for specific pathology while A4B2, 5HTT, and 5HT1a for common pathology. Gene expression was enriched in PLEKHO1, SCN2A, POU3F2, and ANK3. Our study provides new insights into possible neurobiological interpretation for episode phases in the bipolar spectrum and holds promise for advancing personalized precision medicine approaches targeting various episodes of the condition.