This diagnostic comparison chart displays four stacked Proton Nuclear Magnetic Resonance (1H NMR) spectra of human plasma, used in metabolomics research to identify potential biomarkers for Bipolar Disorder (BD). The spectra are arranged vertically and share a common horizontal x-axis representing chemical shift (f1) in parts per million (ppm), ranging from -5 to 14 ppm. The four groups represented include three clinical phases of Bipolar Disorder: BM (mixed episodes), BH (mania/hypomania episodes), and BE (depressive episodes), alongside an HC (healthy control) group. Visually, each spectrum shows a prominent peak at approximately 4.8 ppm (typically associated with water suppression or specific serum metabolites) and a cluster of smaller peaks in the aliphatic region between 0 and 4 ppm, containing markers like lipids, N-acetyl-glycoprotein, and organic acids. Differences in peak height and area across the groups indicate variations in metabolite concentrations, suggesting distinct metabolic profiles for different BD clinical states compared to controls. This image illustrates the application of spectroscopy in psychiatry for metabolic phenotyping.

This composite diagnostic image presents findings from a functional magnetic resonance imaging (fMRI) study focusing on neuroimaging biomarkers in Bipolar Disorder (BD). The figure is divided into six panels (A–F), displaying coronal brain sections at y = -78, specifically targeting the left and right Cerebellum Posterior Lobe (CPL). Panels A and B illustrate clusters of altered dynamic fractional amplitude of low-frequency fluctuations (dfALFF), while C and D show changes in dynamic degree centrality (dDC). Heat maps overlaid on grayscale structural templates indicate the intensity of these dynamic variabilities. Panels E and F provide a spatial comparison using a color-coded overlap analysis: red represents dfALFF regions, green represents dDC regions, and yellow indicates voxels where both parameters overlap. Accompanying each fMRI slice is a box plot comparing euthymic BD patients (EP), depressed BD patients (DP), and healthy controls (HC). The charts demonstrate significantly lower variability in the euthymic group compared to both depressed patients and healthy controls. This educational graphic illustrates the use of resting-state fMRI metrics to distinguish clinical states within the bipolar spectrum, highlighting the cerebellum's involvement in the pathophysiology of mood disorders.

This Comparison Chart displays two 24-hour actigraph recordings (accelerometry) from a single patient with bipolar disorder, illustrating motor activity patterns during different clinical states. The x-axis represents time from 11:00 (11h) to 11:00 the following day, while the y-axis measures activity counts in gravitational force equivalents. Graph A depicts the patient in a manic state, characterized by high-amplitude, high-frequency activity peaks and sustained nocturnal movements, particularly between 00h and 06h, indicating significant psychomotor agitation and reduced sleep. Graph B represents the same patient in remission (euthymic state), showing a marked reduction in overall motor activity. Notably, Graph B demonstrates a flattened baseline with minimal fluctuations during the overnight hours (00h to 06h), reflecting a more regular circadian rhythm and normalized sleep-wake patterns. This visual data serves as an educational tool in psychiatry for understanding the objective physiological manifestations of mood episodes and the quantification of psychomotor activity changes in affective disorders.