Alterations in activity and connectivity of brain circuits implicated in emotion processing and emotion regulation have been observed during resting-state for different clinical phases of bipolar disorders (BD), but longitudinal investigations across different mood states in the same patients are still rare. Furthermore, measuring dynamics of functional connectivity patterns offers a powerful method to explore changes in the brain intrinsic functional organization across mood states. We used a novel co-activation pattern (CAP) analysis to explore the dynamics of amygdala connectivity at rest in a cohort of 20 BD patients prospectively followed-up and scanned across distinct mood states: euthymia (20 patients; 39 sessions), depression (12 patients; 18 sessions), or mania/hypomania (14 patients; 18 sessions). We compared them to 41 healthy controls scanned once or twice (55 sessions). We characterized temporal aspects of dynamic fluctuations in amygdala connectivity over the whole brain as a function of current mood. We identified 6 distinct networks describing amygdala connectivity, among which an interoceptive-sensorimotor CAP exhibited more frequent occurrences during hypomania compared to other mood states, and predicted more severe symptoms of irritability and motor agitation. In contrast, a limbic CAP comprising the hippocampus and ventral tegmental area exhibited fewer occurrences during both depression and hypomania compared to euthymia. Our results reveal distinctive interactions between amygdala and distributed brain networks in different mood states, and foster research on interoception systems especially during the manic phase. Our study also demonstrates the benefits of assessing brain dynamics in BD.

中文翻译：

---

双相情感障碍中杏仁核连接的动力学：跨情绪状态的纵向研究

在双相情感障碍（BD）不同临床阶段的静息状态下，已经观察到涉及情绪处理和情绪调节的大脑回路活动和连通性的变化，但是在同一患者中跨不同情绪状态进行纵向调查的情况仍然很少。此外，测量功能连接模式的动态性提供了一种强大的方法来探索情绪状态下大脑内在功能组织的变化。我们使用一种新颖的共激活模式（CAP）分析来探讨一组20名BD患者的静息状态下杏仁核连通性的动态情况，这些患者均进行了预期随访并在不同的情绪状态下进行了扫描：伴有胸痹（20例患者; 39个疗程），抑郁症（ 12位患者； 18个疗程）或躁狂/低躁狂症（14位患者； 18个疗程）。我们将它们与扫描一次或两次（55次）的41个健康对照进行比较。我们表征了整个大脑的杏仁核连通性的动态波动的时间方面作为当前情绪的函数。我们确定了6个不同的描述杏仁核连通性的网络，其中，与其他情绪状态相比，感知觉-感觉运动CAP在轻躁狂期间表现出更频繁的发生，并预测了更严重的烦躁和运动躁动症状。相比之下，与海豚症相比，包括海马体和腹侧被盖区的边缘性CAP在抑郁症和轻躁狂症中均较少出现。我们的研究结果揭示了杏仁核与不同情绪状态下的分布式大脑网络之间的独特相互作用，并促进了对互感系统的研究，尤其是在躁狂期。