Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression

E. Ambrosi, D. B. Arciniegas, A. Madan, K. N. Curtis, M. A. Patriquin, R. E. Jorge, G. Spalletta, James Chris Fowler, B. C. Frueh, R. Salas

Research output: Contribution to journalArticlepeer-review

78 Scopus citations


Objective: Distinguishing depressive episodes due to bipolar disorder (BD) or major depressive disorder (MDD) solely on clinical grounds is challenging. We aimed at comparing resting-state functional connectivity (rsFC) of regions subserving emotional regulation in similarly depressed BD and MDD. Method: We enrolled 76 in-patients (BD, n = 36; MDD, n = 40) and 40 healthy controls (HC). A seed-based approach was used to identify regions showing different rsFC with the insula and the amygdala. Insular and amygdalar parcellations were then performed along with diagnostic accuracy of the main findings. Results: Lower rsFC between the left insula and the left mid-dorsolateral prefrontal cortex and between bilateral insula and right frontopolar prefrontal cortex (FPPFC) was observed in BD compared to MDD and HC. These results were driven by the dorsal anterior and posterior insula (PI). Lower rsFC between the right amygdala and the left anterior hippocampus was observed in MDD compared to BD and HC. These results were driven by the centromedial and laterobasal amygdala. Left PI/right FPPC rsFC showed 78% accuracy differentiating BD and MDD. Conclusion: rsFC of amygdala and insula distinguished between depressed BD and MDD. The observed differences suggest the possibility of differential pathophysiological mechanisms of emotional dysfunction in bipolar and unipolar depression.

Original languageEnglish (US)
Pages (from-to)129-139
Number of pages11
JournalActa Psychiatrica Scandinavica
Issue number1
StatePublished - Jul 2017


  • bipolar disorder
  • depression
  • functional magnetic resonance imaging
  • major depression

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression'. Together they form a unique fingerprint.

Cite this