{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:13:55Z","timestamp":1786119235234,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bipolar disorder (BD) is a severe psychiatric condition characterized by recurrent episodes of mania and depression. A critical aspect of BD is phase switching, the rapid transition between affective states, which remains poorly understood at the neurobiological level. Recent neuroimaging advancements, particularly in diffusion tensor imaging (DTI) and tractography, have provided insights into the structural white matter (WM) alterations associated with mood transitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an integrated diffusion neuroimaging study to investigate WM modifications in BD patients experiencing manic and depressive phases, as well as those undergoing phase switching. Thirty\u2010two BD type I patients (14 manic, 18 depressive) and 20 healthy controls underwent Magnetic Resonance Imaging scanning, including DTI\u2010based analyses. WM integrity was assessed using Tract\u2010Based Spatial Statistics (TBSS) and tractography to explore fractional anisotropy (FA) differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to healthy controls and depressive BD patients, manic BD patients exhibited significant FA reductions in the corpus callosum, anterior limb of the internal capsule, and thalamic projections. Tractography revealed local FA alterations in fronto\u2010limbic and occipito\u2010parietal pathways, suggesting disrupted structural connectivity. Phase switching was associated with reduced FA in the right superior longitudinal fasciculus III, indicating its potential role as a neurobiomarker of mood instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings highlight widespread WM abnormalities in BD, particularly in manic phases, and suggest a neurobiological signature for phase switching. Understanding these alterations can improve early detection, targeted interventions, and personalized treatment approaches for BD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70131","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:40:27Z","timestamp":1781674827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["White Matter Changes During Manic and Depressive Episodes and Phase Switching in Bipolar Disorder: A Tractography Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4750-1980","authenticated-orcid":false,"given":"Giuseppe","family":"Delvecchio","sequence":"first","affiliation":[{"name":"Department of Neurosciences and Mental Health Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan 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Ca\u2019 Granda, Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Callari","sequence":"additional","affiliation":[{"name":"Department of Neurosciences and Mental Health Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Nosari","sequence":"additional","affiliation":[{"name":"Department of Neurosciences and Mental Health Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Maria","family":"Triulzi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"},{"name":"Department of Neuroradiology Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico  Milan 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