Viglione Aurelia, Delli Colli Claudia, Poggini Silvia, Mobasher Melika, Vai Benedetta, Poletti Sara, Benedetti Francesco, Branchi Igor
Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy; Department of Psychology, Cognitive Neuroscience Master degree, Sapienza University, Rome, Italy.
J Affect Disord. 2025 Oct 15;387:119549. doi: 10.1016/j.jad.2025.119549. Epub 2025 May 27.
Bipolar disorder (BD) and major depressive disorder (MDD) are often misdiagnosed due to overlapping symptomatology, leading to inappropriate treatments and poor outcomes. Thus, novel approaches for effective early differential diagnosis are warranted. Plasticity - the ability to modify brain functioning and mental state - is increasingly recognized as a crucial process in psychiatry, as it underlies transitions from psychopathology to wellbeing. Accordingly, enhanced plasticity is reported to increase mental state transitions. Since BD patients experience transitioning between depression and mania, we hypothesized this disorder to be characterized by higher plasticity levels than MDD.
We leveraged a recent network-based approach to measure plasticity, operationalizing it as the inverse of the connectivity strength among network symptoms. We analyzed 211 BD and 136 MDD patients undergoing a major depressive episode. Symptoms were employed to generate unregularized networks via Gaussian Graphical Model, with Spearman's Rank correlation estimating the input matrix. Connectivity strength was compared between disorders using the Network Comparison Test function.
BD patients exhibit higher plasticity levels than MDD patients, as demonstrated by weaker symptom connectivity, despite both groups having comparable depressive symptom severity (p = 0.008). Within the BD group, type I patients showed also higher plasticity compared to type II (p = 0.04), further corroborating the association between high plasticity and mood instability.
Our findings support the hypothesis that plasticity levels differ across psychopathological conditions based on their likelihood of mental transitions. Consequently, measuring of plasticity through symptom network dynamics holds promise for the early differential diagnosis of BD and MDD.
双相情感障碍（BD）和重度抑郁症（MDD）常因症状重叠而被误诊，导致治疗不当和预后不佳。因此，需要新的有效早期鉴别诊断方法。可塑性——即改变大脑功能和心理状态的能力——在精神病学中越来越被视为一个关键过程，因为它是从精神病理学向健康状态转变的基础。相应地，据报道增强的可塑性会增加心理状态的转变。由于双相情感障碍患者会经历抑郁和躁狂之间的转变，我们假设这种疾病的特征是可塑性水平高于重度抑郁症。
我们利用最近基于网络的方法来测量可塑性，将其定义为网络症状之间连接强度的倒数。我们分析了211名双相情感障碍患者和136名正在经历重度抑郁发作的重度抑郁症患者。通过高斯图形模型使用症状生成非正则化网络，用斯皮尔曼等级相关估计输入矩阵。使用网络比较测试函数比较不同疾病之间的连接强度。
双相情感障碍患者表现出比重度抑郁症患者更高的可塑性水平，这表现为症状连接较弱，尽管两组的抑郁症状严重程度相当（p = 0.008）。在双相情感障碍组中，I型患者也比II型患者表现出更高的可塑性（p = 0.04），进一步证实了高可塑性与情绪不稳定之间的关联。
我们的研究结果支持以下假设，即可塑性水平因精神状态转变的可能性在不同精神病理状况下存在差异。因此，通过症状网络动态测量可塑性有望用于双相情感障碍和重度抑郁症的早期鉴别诊断。
