In this episode of The Biological Psychiatry Podcast, Dr. Elvisha Dhamala sits down with Dr. Leila Nabulsi from the University of Southern California to discuss her recent paper published in Biological Psychiatry.
The brain doesn't work as a collection of isolated parts, it works as a network, with white matter pathways acting as the wires that connect regions into functional circuits. But understanding how those connections are altered in bipolar disorder has been difficult, largely because most studies have been too small or too variable in their methods to produce reliable answers. In this conversation, we explore how the ENIGMA Bipolar Disorder Working Group tackled this challenge by pooling diffusion MRI data from 16 sites around the world to map structural brain network disruptions in bipolar disorder. Dr. Nabulsi walks us through what it means to think of the brain as a network, why individuals with bipolar disorder showed reduced network efficiency and disrupted connectivity in limbic, fronto-limbic, and default mode circuits, and how clinical features like illness duration, psychosis history, and medication use relate to these network changes. We also discuss what these findings might mean for the everyday experiences of people living with bipolar disorder and where the field goes from here.
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