Bipolar Disorders最新文献

{"title":"Plasma Glial Fibrillary Acidic Protein and Neurofilament Light Are Elevated in Bipolar Depression: Evidence for Neuroprogression and Astrogliosis","authors":"Matthew J. Y. Kang,&nbsp;Dhamidhu Eratne,&nbsp;Olivia Dean,&nbsp;Michael Berk,&nbsp;Adam J. Walker,&nbsp;Cassandra Wannan,&nbsp;Charles B. Malpas,&nbsp;Claudia Cicognola,&nbsp;Shorena Janelidze,&nbsp;Oskar Hansson,&nbsp;Jasleen Grewal,&nbsp;Philip B. Mitchell,&nbsp;Malcolm Hopwood,&nbsp;Christos Pantelis,&nbsp;Alexander F. Santillo,&nbsp;Dennis Velakoulis","doi":"10.1111/bdi.70029","DOIUrl":"10.1111/bdi.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent advances now allow detection of brain-specific proteins in blood, including neurofilament light chain (NfL), a marker of axonal pathology, and glial fibrillary acidic protein (GFAP), indicative of astrocytic activation. Given the evidence of astroglial pathology and neuronal dysfunction in bipolar disorder, and ongoing debates on neuroprogression, we investigated plasma NfL and GFAP levels in affected individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analysed plasma NfL and GFAP measured in 216 individuals using Simoa. We used bootstrapped general linear models (GLM) to compare plasma NfL and GFAP levels between people with bipolar depression (<i>n</i> = 120) and healthy controls (<i>n</i> = 96), adjusting for age, sex, and weight. We examined associations between these biomarkers and clinical variables while adjusting for multiple comparisons. For sensitivity analyses, predictors were evaluated using Bayesian model averaging (BMA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Plasma GFAP (<i>β</i> = 0.21 [0.07, 0.35], <i>p</i> = 0.006) and NfL (<i>β</i> = 0.06 [0.01, 0.10], <i>p</i> = 0.028) were elevated in people with bipolar depression. Illness duration was positively associated with NfL (<i>r</i> = 2.97, <i>p</i> = 0.002), and further supported by BMA analysis (posterior inclusion probability, PIP = 0.85). Age of onset was positively associated with GFAP (<i>r</i> = 0.246 <i>p</i> = 0.041), which was also supported by BMA analysis (PIP = 0.67).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicate increased plasma NfL and GFAP levels in bipolar disorder. Our findings support the neuroprogression hypothesis, where prolonged illness duration contributes to neuroaxonal damage. Elevated GFAP in those with later onset suggests a role for neuroinflammation, potentially linked to increased cardiovascular and metabolic comorbidities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"379-388"},"PeriodicalIF":4.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Theta Burst Stimulation Ready as a Clinical Treatment for Bipolar Disorder?","authors":"Yufei Wu,&nbsp;Danni Yan,&nbsp;Jianli Yang","doi":"10.1111/bdi.70025","DOIUrl":"10.1111/bdi.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To date, no studies have investigated the efficacy of theta burst stimulation (TBS) in the treatment of bipolar disorder (BD), and the results are inconclusive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aim to systematically review the existing literature related to the efficacy of TBS in BD and synthesize the results through meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched for PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of science, PsycINFO, CNKI, and Wan fang databases without language restriction through July 30, 2023, and included randomized-controlled trials that assessed the treatment effect of TBS in patients with BD. We used a random-effects model to pool effect sizes, which were expressed as Cohen's d (or Odds ratio) and 95% confidence intervals (CIs). The outcome measures include changes in Montgomery-Asberg Depression Rating Scale (MADRS) scores, response and remission rates of depression, and dropout rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Eight randomized sham-controlled trials were included in the meta-analysis. The overall effect size of the outcome measures, including changes in MARDS scale scores, response rate, and remission rates, were −0.81 (95% confidence interval [CI]: 4.07 to 2.44), 1.07 (95% CI: 0.47 to 2.44) and 0.74 (95% CI: 0.38 to 1.45), respectively. Notably, the TBS group showed favorable efficacy without major adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current studies indicate that TBS does not show significant antidepressant efficacy in patients with BD, although it is very well tolerated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 3","pages":"180-191"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine's Influence on Magnetoencephalography Patterns During a Working Memory Task in Treatment-Resistant Depression: An Exploratory Study","authors":"Adam Fijtman,&nbsp;Mani Yavi,&nbsp;Abigail Vogeley,&nbsp;Dede Greenstein,&nbsp;Jessica R. Gilbert,&nbsp;Carlos A. Zarate Jr","doi":"10.1111/bdi.70027","DOIUrl":"10.1111/bdi.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Treatment-resistant depression (TRD) remains a challenge, necessitating novel interventions that address associated cognitive deficits. The glutamatergic modulator ketamine exerts rapid antidepressant effects, prompting investigators to assess its impact on cognitive function, specifically working memory. This study explored ketamine's influence on working memory and magnetoencephalography (MEG) patterns during a working memory task in individuals with TRD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the effects of ketamine on working memory, attention, and concentration, and to study MEG patterns during a working memory task in individuals with TRD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one individuals with TRD (14 with bipolar disorder, 7 with major depressive disorder) received ketamine and placebo infusions in a crossover trial. Behavioral and MEG data were collected at baseline and 6 to 9 h after ketamine and placebo (normal saline) infusion. Working memory, attention, and concentration were assessed with the N-back task.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ketamine significantly improved depressive symptoms but had no effect on cognitive performance. MEG revealed increased gamma power in the parieto-occipital junction coupled with decreased gamma power in the posterior superior temporal sulcus and inferior frontal gyrus after ketamine administration compared to placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite robust antidepressant effects, ketamine did not affect working memory, attention, or concentration. However, distinct gamma power changes in brain regions linked to attention and working memory highlight the need to further explore the neurobiological mechanisms underlying ketamine's cognitive effects in TRD. Future research with larger samples, broader cognitive batteries, and repeated ketamine infusions are needed to fully elucidate ketamine's cognitive effects in individuals with TRD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"316-322"},"PeriodicalIF":5.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra High Dose (252 mg/Day) Lorazepam Infusion for Delirium in a Patient With Bipolar Disorder, TBI and Substance Withdrawal in ICU","authors":"Francesco Fargnoli,&nbsp;Valentina Lo Serro,&nbsp;Pasquale D'onofrio,&nbsp;Alessandro Cuomo,&nbsp;Pietro Carmellini,&nbsp;Giovanni Barillà,&nbsp;Simone Pardossi,&nbsp;Letizia Nucci,&nbsp;Valeria Peccianti,&nbsp;Silvia Montemerani,&nbsp;Elena Falciani,&nbsp;Vincenzo Giannubilo,&nbsp;Andrea Fagiolini","doi":"10.1111/bdi.70030","DOIUrl":"10.1111/bdi.70030","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"396-398"},"PeriodicalIF":4.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Overall Topological Impairments of Functional Brain Networks Across Diverse State of Bipolar Disorder With Relevance to Cognitive Deficits and Genetic and Transcriptomic Variations","authors":"Yudan Ding,&nbsp;Huabing Li,&nbsp;Feng Liu,&nbsp;Ping Li,&nbsp;Jingping Zhao,&nbsp;Dongsheng Lv,&nbsp;Wenbin Guo","doi":"10.1111/bdi.70028","DOIUrl":"10.1111/bdi.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Investigating brain network properties in BD patients across mood states can offer insights into the underlying mechanisms of the disorder. This study aimed to explore the topological architecture of functional brain networks in BD and its relationship with clinical variables and genetic/transcriptomic variations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study involved 100 BD patients and 95 healthy controls. Researchers used graph theory-based methods to analyze whole-brain functional networks and explore their relationship with clinical variables. We also conducted a neuroimaging-transcription association analysis using the Allen Human Brain Atlas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Depressive and manic BD patients exhibited increased local efficiency and decreased global efficiency at the global network level compared to healthy controls. Nodal-level analysis revealed disrupted nodal parameters within specific brain networks, including the fronto-parietal, default mode, and somatomotor networks. Significant correlations were found between nodal properties and cognitive function. All BD groups showed enhanced connectivity strength in rich-club and feeder connections compared to controls. Neuroimaging-transcription analysis identified potential genetic factors related to BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our investigation unveiled shared impairments in the overall topological architecture of functional brain networks across depressive, manic, and euthymic BD. These observed abnormalities were associated with cognitive deficits in BD patients across three mood states. These common deficits, possibly stemming from the segregated changes in structural and functional rich-club connections, might represent trait-like pathophysiological mechanisms inherent to BD. Furthermore, our neuroimaging-transcription association analysis indicates the potential use of brain functional anomalies as endophenotypes in BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"365-378"},"PeriodicalIF":4.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Predisposing to the Onset of Bipolar Disorder: A 30-Year Longitudinal Study","authors":"Peter Tyrer,&nbsp;Min Yang,&nbsp;Helen Tyrer,&nbsp;Gin Malhi","doi":"10.1111/bdi.70026","DOIUrl":"10.1111/bdi.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the factors that predict the development of bipolar disorder in a population presenting with anxiety and depressive disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In a 30-year study, the Nottingham Study of Neurotic Disorder, the personality status, life events, service data, and early course of patients recruited to a randomised controlled trial were compared in patients who developed bipolar pathology and those who had no bipolar symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 30 years, 5 (2.5%) of 200 patients assessed at baseline developed unequivocal bipolar disorder, one within the first 10 weeks of the study, and three (1.5%) had bipolar II pathology. Analysis of these data showed that those patients who had some degree of bipolarity had an increase in anxiety and depressive symptoms and general psychopathology, most pronounced in the second year of the study, that was not found with patients who had no bipolar pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients treated for anxiety and depressive disorders who remain unwell after initial treatment are more at risk of developing bipolar disorder than others.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"310-315"},"PeriodicalIF":5.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Authentic Portrait of a Manic Episode From the Artistic Perspective of a Patient With Bipolar Disorder","authors":"Onur Gökçen,&nbsp;Ceyhun Yilmaz","doi":"10.1111/bdi.70023","DOIUrl":"10.1111/bdi.70023","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"331-333"},"PeriodicalIF":5.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Upper Gastrointestinal Bleeding in a Patient With Bipolar II Disorder and Catatonia: A Case Report","authors":"Ranxi Deng,&nbsp;Wanjing Yang,&nbsp;Jingyuan Zhou,&nbsp;Hongqi Xiao,&nbsp;Yingxu Duan,&nbsp;Lixin Shi,&nbsp;Changjian Qiu","doi":"10.1111/bdi.70024","DOIUrl":"10.1111/bdi.70024","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"389-392"},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White Matter, Cognition, and Electrophysiological Variables in Bipolar Disorder: Using Multimodal Integration of Biomarker Variables Associated With Bipolar Disorder to Elucidate Deficits","authors":"Audrey Berardi,&nbsp;Jennifer A. Brown,&nbsp;Brooke S. Jackson,&nbsp;Ling-Yu Huang,&nbsp;Rebekah L. Trotti,&nbsp;David A. Parker,&nbsp;Scot K. Hill,&nbsp;Elena Ivleva,&nbsp;Godfrey D. Pearlson,&nbsp;Carol A. Tamminga,&nbsp;Matcheri S. Keshavan,&nbsp;Sarah K. Keedy,&nbsp;Elliot S. Gershon,&nbsp;John A. Sweeney,&nbsp;Brett A. Clementz,&nbsp;Jennifer E. McDowell","doi":"10.1111/bdi.70010","DOIUrl":"10.1111/bdi.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate associations in bipolar disorder (BD) across multimodal measures of white matter microstructure (using diffusion tensor imaging; DTI), cognitive, behavioral, and brain electrophysiological measures (using electroencephalography; EEG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Subjects were recruited through the Psychosis and Affective Research Domains and Intermediate Phenotypes Consortium (<i>n</i> = 45 bipolar with psychosis, <i>n</i> = 40 bipolar without psychosis, <i>n</i> = 66 healthy subjects). DTI data were used to quantify the white matter variables, fractional anisotropy (FA) and radial diffusivity (RD). The Brief Assessment of Cognition in Schizophrenia (BACS), Stop Signal Task (SST), pro- and anti-saccades, auditory event-related potentials (ERPs), and intrinsic brain activity were used as estimates of brain function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The combined BD group differed from healthy controls, but no differences between BD with and without psychosis were observed. BD-related white matter abnormalities were seen across multiple tracts: right cingulum–cingulate gyrus, bilateral anterior thalamic radiation, bilateral superior longitudinal fasciculus, right inferior longitudinal fasciculus, and forceps major. Results also showed modestly compromised cognitive performance and elevated intrinsic EEG activity associated with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Further analysis indicated worse white matter integrity related to higher intrinsic EEG and modestly higher ERPs. These multimodal analyses are likely to aid in creating future informative diagnostic, etiological, and treatment targets for BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 3","pages":"205-216"},"PeriodicalIF":5.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Machine Learning Prediction of 12-Month Suicide Attempts in Bipolar Disorder","authors":"Alessandro Pigoni,&nbsp;Isidora Tesic,&nbsp;Cecilia Pini,&nbsp;Paolo Enrico,&nbsp;Lorena Di Consoli,&nbsp;Francesca Siri,&nbsp;Guido Nosari,&nbsp;Adele Ferro,&nbsp;Letizia Squarcina,&nbsp;Giuseppe Delvecchio,&nbsp;Paolo Brambilla","doi":"10.1111/bdi.70011","DOIUrl":"10.1111/bdi.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Bipolar disorder (BD) patients present an increased risk of suicide attempts. Most current machine learning (ML) studies predicting suicide attempts are cross-sectional, do not employ time-dependent variables, and do not assess more than one modality. Therefore, we aimed to predict 12-month suicide attempts in a sample of BD patients, using clinical and brain imaging data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sample of 163 BD patients were recruited and followed up for 12 months. Gray matter volumes and cortical thickness were extracted from the T1-weighted images. Based on previous literature, we extracted 56 clinical and demographic features from digital health records. Support Vector Machine was used to differentiate BD subjects who attempted suicide. First, we explored single modality prediction (clinical features, GM, and thickness). Second, we implemented a multimodal stacking-based data fusion framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the 12 months, 6.13% of patients attempted suicide. The unimodal classifier based on clinical data reached an area under the curve (AUC) of 0.83 and balanced accuracy (BAC) of 72.7%. The model based on GM reached an AUC of 0.86 and BAC of 76.4%. The multimodal classifier (clinical + GM) reached an AUC of 0.88 and BAC of 83.4%, significantly increasing the sensitivity. The most important features were related to suicide attempts history, medications, comorbidities, and depressive polarity. In the GM model, the most relevant features mapped in the frontal, temporal, and cerebellar regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By combining models, we increased the detection of suicide attempts, reaching a sensitivity of 80%. Combining more than one modality proved a valid method to overcome limitations from single-modality models and increasing overall accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 3","pages":"217-231"},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}