The Functional Connectivity Between the Nucleus Accumbens and the Ventromedial Prefrontal Cortex as an Endophenotype for Bipolar Disorder

BACKGROUND: Alterations in functional connectivity between the nucleus accumbens (NAcc) and frontal cortices have been previously associated with the presence of psychiatric syndromes, including bipolar disorder (BD). Whether these alterations are a consequence or a risk factor for mental disorders remains unresolved. METHODS: This study included 35 patients with BD, 30 nonaffected siblings of patients with BD, and 23 healthy control subjects to probe functional connectivity at rest between NAcc and the rest of the brain in a cross-sectional design. Blood oxygen level–dependent time series at rest from NAcc were used as seed region in a voxelwise correlational analysis. The strength of the correlations found was compared across groups after Fisher’s Z transformation. RESULTS: We found increased functional connectivity between the NAcc and the ventromedial prefrontal cortex—comprising mainly the subgenual anterior cingulate—in patients compared with healthy control subjects. Participants at increased genetic risk but yet resilient—nonaffected siblings—showed functional connectivity values midway between the former two groups. CONCLUSIONS: Our results are indicative of the potential for the connectivity between NAcc and the ventromedial prefrontal cortex to represent an endophenotype for BD.