OBJECTIVE Manic and depressive phases of bipolar disorder (BD) show opposite psychomotor symptoms. Neuronally, these may depend on altered relationships between sensorimotor network (SMN) and subcortical structures. The study aimed to investigate the functional relationships of SMN with substantia nigra (SN) and raphe nuclei (RN) via subcortical-cortical loops, and their alteration in bipolar mania and depression, as characterized by psychomotor excitation and inhibition. METHOD In this resting-state functional magnetic resonance imaging (fMRI) study on healthy (n = 67) and BD patients (n = 100), (1) functional connectivity (FC) between thalamus and SMN was calculated and correlated with FC from SN or RN to basal ganglia (BG)/thalamus in healthy; (2) using an a-priori-driven approach, thalamus-SMN FC, SN-BG/thalamus FC, and RN-BG/thalamus FC were compared between healthy and BD, focusing on manic (n = 34) and inhibited depressed (n = 21) patients. RESULTS (1) In healthy, the thalamus-SMN FC showed a quadratic correlation with SN-BG/thalamus FC and a linear negative correlation with RN-BG/thalamus FC. Accordingly, the SN-related FC appears to enable the thalamus-SMN coupling, while the RN-related FC affects it favoring anti-correlation. (2) In BD, mania showed an increase in thalamus-SMN FC toward positive values (ie, thalamus-SMN abnormal coupling) paralleled by reduction of RN-BG/thalamus FC. By contrast, inhibited depression showed a decrease in thalamus-SMN FC toward around-zero values (ie, thalamus-SMN disconnection) paralleled by reduction of SN-BG/thalamus FC (and RN-BG/thalamus FC). The results were replicated in independent HC and BD datasets. CONCLUSIONS These findings suggest an abnormal relationship of SMN with neurotransmitters-related areas via subcortical-cortical loops in mania and inhibited depression, finally resulting in psychomotor alterations.

中文翻译：

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在双相情感障碍的躁狂和抑郁期，感觉运动网络与神经递质相关核通过皮层下-皮层环的异常功能关系。

目的躁郁症和躁郁症双相情感障碍（BD）表现出相反的精神运动症状。在神经元上，这些可能取决于感觉运动网络（SMN）与皮层下结构之间关系的改变。这项研究旨在通过皮层下皮质环研究SMN与黑质（SN）和沟纹核（RN）的功能关系，以及它们在双相性躁狂和抑郁症中的变化，其特征是精神运动性兴奋和抑制。方法在这项针对健康人（n = 67）和BD患者（n = 100）的静止状态功能磁共振成像（fMRI）研究中，（1）计算了丘脑和SMN之间的功能连接性（FC），并将其与SN中的FC相关联或健康的RN到基底神经节（BG）/丘脑; （2）使用先验驱动的方法，丘脑SMN FC，SN-BG /丘脑FC，比较健康人和BD人的RN-BG /丘脑FC和RN-BG /丘脑FC，重点是躁狂（n = 34）和抑制性抑郁（n = 21）患者。结果（1）在健康人群中，丘脑-SMN FC与SN-BG /丘脑FC呈二次相关，与RN-BG /丘脑FC呈线性负相关。因此，SN相关的FC似乎能够实现丘脑-SMN耦合，而RN相关的FC影响其有利于反相关。（2）在BD中，躁狂症显示丘脑SMN FC向阳性值增加（即丘脑SMN异常偶联），同时RN-BG /丘脑FC减少。相比之下，抑制性抑郁显示丘脑-SMN FC朝着零值附近降低（即丘脑-SMN断开），同时SN-BG /丘脑FC（和RN-BG /丘脑FC）降低。将结果复制到独立的HC和BD数据集中。