Page 10 - JCBP-3-4

Journal of Clinical and
Basic Psychosomatics Neuroimaging of bipolar disorder and self-stigma

Table 1. The main findings of functional magnetic resonance imaging in bipolar disorder
Authors Year Comparison objects=sample Imaging Main findings
size methods
Zhang et al. 21 2022 Bipolar depression patients=39; rs-fMRI Decreased functional connectivity between the thalamus and frontal
HC=26 cortex was associated with an increased risk of suicide.
Zeng et al. 17 2023 Bipolar depression patients=38; rs-fMRI (i) BD patients exhibited decreased sensorimotor-thalamic functional
Bipolar remission patients=40; connectivity, which may be a characteristic of BD.
HC=39 (ii) Bipolar depression exhibited reduced prefrontal-thalamic functional
connectivity compared to bipolar remission, which may be related to
the state of BD in patients with BD.
Saleem et al. 23 2023 BD=109; HC=79 BOLD-fMRI (i) The functional connections of the cerebellar vermis in patients
with bipolar depression were increased with motor control and
emotion-related brain regions, while the connectivity of areas related
to language production was reduced.
(ii) The functional connections between cerebellar vermis and other
regions were negatively correlated with emotional ratings, which may
suggest that cerebellar vermis plays a compensatory role.
Zhang et al. 27 2023 BD=66; HC=60 rs-fMRI (i) When compared to HC, bipolar mania patients exhibited increased
network homogeneity in the left middle frontal gyrus, while remitted
BD patients exhibited increased network homogeneity in the right
inferior parietal lobule.
(ii) In comparison to remitted BD patients, bipolar mania patients
exhibited decreased network homogeneity in the right inferior
parietal lobule.
Gupta et al. 29 2022 Bipolar remission patients=25; 1 H-MRS (i) The patients exhibited significantly decreased NAA levels in the
HC=20 dorsolateral PFC and hippocampus, and Glu levels in hippocampus,
while the levels of inositol and glutamine in hippocampus were
increased.
(ii) Changes in neurometabolites were associated with cognitive
impairment in patients with BD.
Kong et al. 32 2023 BD=20; Unipolar MRS (i) In BD patients, the Glu levels were significantly elevated in the
depression=30; HC=20 DKI bilateral ventral PWM, and choline levels were reduced in the left
ventral PWM and ACC.
(ii) Abnormal microstructure and neurometabolic changes in both
unipolar depression and BD patients, and changes in the prefrontal
region were not completely consistent, which may help to differentiate
between the two diseases.
Scotti-Muzzi 2021 BD I=50; HC=38 1 H-MRS (i) The Glu/GABA ratio in the dorsal ACC in BD patients was reduced,
et al. 35 JPRESS which was affected by anticonvulsants and antipsychotics, but not by
lithium.
(ii) BD patients with GAD1 rs1978340 allele A had a higher Glu/GABA
ratio.
Magnotta et al. 40 2022 BD I=64; HC=42 1 H-MRS The concentrations of NAA, Glu, glutathione, taurine, and Cr were
3 1P-MRS increased in the cerebellar vermis and the right putamen, while the
intracellular pH was decreased.
Lai et al. 44 2021 BD II=106; HC=100 1 H-MRS Compared with HC, the NAA/Cr ratio in the PFCs of BD II patients
was significantly lower, while the NAA/Cr ratio in the left thalamus was
significantly higher.
Abbreviations: H-MRS: Proton magnetic resonance spectroscopy; P-MRS: Phosphorus magnetic resonance spectroscopy; ACC: Anterior cingulate
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cortex; BD: Bipolar disorder; BOLD-fMRI: Blood oxygen level-dependent functional magnetic resonance imaging; Cr: Creatine; DKI: Diffusion
kurtosis imaging; GABA: Gamma-aminobutyric acid; Glu: Glutamate; HC: Healthy controls; JPRESS: J - resolved Point - Resolved Spectroscopy; MRS:
Magnetic resonance spectroscopy; NAA: N-acetylaspartate; PFC: Prefrontal cortex; PWM: Prefrontal white matter; rs-fMRI: Resting-state functional
magnetic resonance imaging.
the cerebellar vermis of patients with BD were significantly no significant changes in the ratios of NAA/Cr, Cho/Cr,
elevated, with a trend of increase also observed in the and mI/Cr in the putamen of BD patients compared to
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putamen. Previous studies also reported that there were healthy controls. A study by Cao et al. reported that Cho
Volume 3 Issue 4 (2025) 4 doi: 10.36922/jcbp.8413