ObjectiveTo explore the changes in dynamic functional brain network connectivity (dFNC) in patients with early-onset bipolar disorder (BD).MethodsResting-state functional magnetic resonance imaging (rs-fMRI) data were collected from 39 patients with early-onset BD and 22 healthy controls (HCs). Four repeated and stable dFNC states were characterised by independent component analysis (ICA), sliding time windows and k-means clustering, and three dFNC temporal metrics (fraction of time, mean dwell time and number of transitions) were obtained. The dFNC temporal metrics and the differences in dFNC between the two groups in different states were evaluated, and the correlations between the differential dFNC metrics and neuropsychological scores were analysed.ResultsThe dFNC analysis showed four connected patterns in all subjects. Compared with the HCs, the dFNC patterns of early-onset BD were significantly altered in all four states, mainly involving impaired cognitive and perceptual networks. In addition, early-onset BD patients had a decreased fraction of time and mean dwell time in state 2 and an increased mean dwell time in state 3 (p< 0.05). The mean dwell time in state 3 of BD showed a positive correlation trend with the HAMA score (r = 0.4049,p= 0.0237 × 3 > 0.05 after Bonferroni correction).ConclusionPatients with early-onset BD had abnormal dynamic properties of brain functional network connectivity, suggesting that their dFNC was unstable, mainly manifesting as impaired coordination between cognitive and perceptual networks. This study provided a new imaging basis for the neuropathological study of emotional and cognitive deficits in early-onset BD.