Structural Brain Network Alterations in Relation to Treatment and Illness Severity in Bipolar Disorder

L Nabulsi; MJY Kang; N Jahanshad; G McPhilemy; FM Martyn; B Haarman; C McDonald; B Hallahan; S O’Donoghue; DJ Stein; FM Howells; F Scheffler; HS Temmingh; DC Glahn; A Rodrigue; E Pomarol-Clotet; E Vieta; J Radua; R Salvador; A Karuk; EJ Canales-Rodríguez; J Houenou; P Favre; M Polosan; A Pouchon; P Brambilla; M Bellani; PB Mitchell; G Roberts; U Dannlowski; T Borgers; S Meinert; K Flinkenflügel; J Repple; EJ Leehr; D Grotegerd; T Hahn; M Wessa; ML Phillips; L Teutenberg; T Kircher; B Straube; O Steinstraeter; F Stein; F Thomas-Odenthal; N Alexander; PL Usemann; A Jansen; M Berk; O Dandash; N Parker; C Suo; SI Thomopoulos; PM Thompson; OA Andreassen; CRK Ching; DM Cannon

Journal article

Structural Brain Network Alterations in Relation to Treatment and Illness Severity in Bipolar Disorder

L Nabulsi, MJY Kang, N Jahanshad, G McPhilemy, FM Martyn, B Haarman, C McDonald, B Hallahan, S O’Donoghue, DJ Stein, FM Howells, F Scheffler, HS Temmingh, DC Glahn, A Rodrigue, E Pomarol-Clotet, E Vieta, J Radua, R Salvador, A Karuk Show all

Biological Psychiatry | Published : 2026

DOI: 10.1016/j.biopsych.2026.04.020

Abstract

Background Large-scale T1-weighted magnetic resonance imaging (MRI) studies have established gray matter abnormalities in bipolar disorder (BD), with our group contributing to consensus findings. However, structural connectivity, particularly within emotion- and reward-related circuits, remains poorly understood. Diffusion-weighted MRI (dMRI) enables investigation of white matter pathways, but prior work is constrained by small samples, methodological heterogeneity, and unclear medication effects. We conducted the largest dMRI network analysis in BD, relating symptom burden and polypharmacy to tractography-derived connectivity and graph-theoretical metrics. Methods Cross-sectional structural..

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