Bipolar disorder (BD) is a serious mental disorder involving widespread abnormal interactions between brain regions, and it is believed to be associated with imbalanced functions in the brain. However, how this brain imbalance underlies distinct BD symptoms remains poorly understood. Here, we used a nested‐spectral partition (NSP) method to study the segregation, integration, and balance in resting‐state brain functional networks in BD patients and healthy controls (HCs). We first confirmed that there was a high deviation in the brain functional network toward more segregation in BD patients than in HCs and that the limbic system had the largest alteration. Second, we demonstrated a network balance of segregation and integration that corresponded to lower anxiety in BD patients but was not related to other symptoms. Subsequently, based on a machine‐learning approach, we identified different system‐level mechanisms underlying distinct BD symptoms and found that the features related to the brain network balance could predict BD symptoms better than graph theory analyses. Finally, we studied attention‐deficit/hyperactivity disorder (ADHD) symptoms in BD patients and identified specific patterns that distinctly predicted ADHD and BD scores, as well as their shared common domains. Our findings supported an association of brain imbalance with anxiety symptom in BD patients and provided a potential network signature for diagnosing BD. These results contribute to further understanding the neuropathology of BD and to screening ADHD in BD patients.
Schizophrenia is a severe psychotic disorder characterized by positive and negative symptoms, but their neural bases remain poorly understood. Here, we utilized a nested-spectral partition (NSP) approach to detect hierarchical modules in resting-state brain functional networks in schizophrenia patients and healthy controls, and we studied dynamic transitions of segregation and integration as well as their relationships with clinical symptoms. Schizophrenia brains showed a more stable integrating process and a more variable segregating process, thus maintaining higher segregation, especially in the limbic system. Hallucinations were associated with higher integration in attention systems, and avolition was related to a more variable segregating process in default-mode network (DMN) and control systems. In a machine-learning model, NSP-based features outperformed graph measures at predicting positive and negative symptoms. Multivariate analysis confirmed that positive and negative symptoms had opposite effects on dynamic segregation and integration of brain networks. Gene ontology analysis revealed that the effect of negative symptoms was related to autistic, aggressive and violent behavior; the effect of positive symptoms was associated with hyperammonemia and acidosis; and the interaction effect was correlated with abnormal motor function. Our findings could contribute to the development of more accurate diagnostic criteria for positive and negative symptoms in schizophrenia.
Cognition involves locally segregated and globally integrated processing. This process is hierarchically organized, linking to evidence from hierarchical modules in brain networks. However, it remains a mystery how flexible transitions between these hierarchical processes are associated with human behavior. Here, we used a multisource interference task and measured hierarchical segregation and integration across multiple levels. Our results show more flexible transitions between segregated and integrated brain states in the task state. Crucially, brain flexibility in resting and task states was associated with human behavior. To achieve a better performance, the resting brain is optimized to be more flexible, such that it is prepared to more efficiently switch into a task state where the brain needs less flexibility to stably perform the task. Our hierarchical modular analysis was more effective in detecting the alterations in functional organization and the phenotype of human behavior than graph-based network measures at a single level.
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