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Anatomical integration and rich-club connectivity in euthymic bipolar disorder

Published online by Cambridge University Press:  13 February 2017

S. O'Donoghue
The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Republic of Ireland
L. Kilmartin
College of Engineering and Informatics, National University of Ireland Galway, Galway, Republic of Ireland
D. O'Hora
School of Psychology, National University of Ireland Galway, Galway, Republic of Ireland
L. Emsell
Translational MRI, Department of Imaging & Pathology, KU Leuven & Radiology, University Hospitals Leuven, Leuven, Belgium
C. Langan
The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Republic of Ireland
S. McInerney
Department of Psychiatry, St Michael's Hospital, Toronto, Ontario, Canada
N. J. Forde
Department of Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
A. Leemans
Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
B. Jeurissen
Vision Lab, University of Antwerp, Antwerp, Belgium
G. J. Barker
Institute of Psychiatry, Psychology and Neuroscience, London, UK
P. McCarthy
Radiology, University Hospital Galway, Galway, Republic of Ireland
D. M. Cannon
The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Republic of Ireland
C. McDonald
The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Republic of Ireland
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Although repeatedly associated with white matter microstructural alterations, bipolar disorder (BD) has been relatively unexplored using complex network analysis. This method combines structural and diffusion magnetic resonance imaging (MRI) to model the brain as a network and evaluate its topological properties. A group of highly interconnected high-density structures, termed the ‘rich-club’, represents an important network for integration of brain functioning. This study aimed to assess structural and rich-club connectivity properties in BD through graph theory analyses.


We obtained structural and diffusion MRI scans from 42 euthymic patients with BD type I and 43 age- and gender-matched healthy volunteers. Weighted fractional anisotropy connections mapped between cortical and subcortical structures defined the neuroanatomical networks. Next, we examined between-group differences in features of graph properties and sub-networks.


Patients exhibited significantly reduced clustering coefficient and global efficiency, compared with controls globally and regionally in frontal and occipital regions. Additionally, patients displayed weaker sub-network connectivity in distributed regions. Rich-club analysis revealed subtly reduced density in patients, which did not withstand multiple comparison correction. However, hub identification in most participants indicated differentially affected rich-club membership in the BD group, with two hubs absent when compared with controls, namely the superior frontal gyrus and thalamus.


This graph theory analysis presents a thorough investigation of topological features of connectivity in euthymic BD. Abnormalities of global and local measures and network components provide further neuroanatomically specific evidence for distributed dysconnectivity as a trait feature of BD.

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Copyright © Cambridge University Press 2017 

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