Adolescent bipolar and depressive disorders show distinct default mode network connectivity

Adolescents with bipolar disorder (BD) and major depressive disorder (MDD) show distinct DMN connectivity patterns. BD had reduced aMPFC-STG/TPOsup connectivity; MDD had stronger aMPFC-STG and pIPL-IFG connectivity vs BD. ML classifier had modest performance (AUC 0.609).

• Distinguishing BD and MDD in adolescents is clinically challenging; these distinct DMN connectivity patterns may provide potential neuroimaging markers for differential diagnosis.
• BD showed significantly reduced FC between aMPFC and bilateral STG/right temporal pole, and between pIPL and left MTG/STG compared to healthy controls; MDD showed no significant differences from controls.
• The SVM classifier had modest and unstable performance (AUC 0.609, accuracy 0.598) under nested 10-fold cross-validation, limiting immediate clinical applicability.

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