Page 11 - JCBP-3-4

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

levels in the putamen and caudate nucleus of BD patients and the right subgenual cortex, and that psychotherapy
were significantly elevated. Another study also observed affected this situation, leading to its reduction. In a study of
increased levels of Cho and total Cr in the putamen and a 12-month social contact intervention for SS, it was found
cerebellar vermis of BD patients compared to controls. that the reduction in SS was associated with increased
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The discrepancies in these findings may be due to factors functional connectivity between the superficial amygdala
such as insufficient sample size and varying symptoms subregion and the cortex within the calcarine fissure.
among BD patients. In a study on the basal ganglia However, there was no significant association between
conducted by Lai et al., it was found that the NAA/Cr changes in amygdala-PFC functional connectivity and
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ratio in the bilateral lenticular nucleus was significantly changes in stigma. In another study using virtual reality
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decreased during both acute and normal phases of BD. interventions, it was shown that the alleviation of stigma
In another study focusing on the thalamus, Lai et al. was related to increased activation in the right superior
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reported a higher NAA/Cr ratio in the left thalamus. frontal gyrus. 53
The aforementioned studies have reported decreased Research using tb-fMRI has found that the ability
NAA levels in the PFC, ACC, and bilateral lenticular of schizophrenic patients to resist stigma is negatively
nuclei of patients with BD. However, there are correlated with the activation intensity of the vmPFC,
inconsistent conclusions regarding changes in the levels of providing preliminary evidence for the association
neurometabolites such as Glx, mI, and Cho, which may be between brain circuits involved in emotion regulation
due to factors such as insufficient sample size and variations and stigma resistance. Krendl et al. found that the
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in the medications used by the patients (Table 1). bilateral amygdalae were more activated in response
3. Progress in functional imaging research to stigma-related information compared to the control
group, while the left ACC showed high activation in
on SS response to negative information. The amygdala and
3.1. Advances in BOLD-fMRI research on SS lateral PFC networks showed compulsory and automatic
characteristics in their response to stigma. Welborn et al.
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Although SS is widespread among patients with mental
disorders, it does not affect all individuals, and this found that stereotyping altered the functional connectivity
is influenced by factors such as the differences in the of the nucleus accumbens in reward-related brain regions.
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internalization of stereotypes and prejudices, as well as Kawamichi et al. discovered increased activation in the
varying abilities to resist stigma. SS is associated with dorsal ACC and anterior insula in response to negative
various negative consequences, including poor adherence, information, which may be related to the ability of these two
low self-efficacy, low self-esteem, non-suicidal self-injury, brain regions to process psychological and physiological
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or suicide. 45-48 Studies have found that these adverse pain stimuli. Krendl et al. found that stigma activation
outcomes may be related to changes in neural functional and self-regulation of SS led to increased PFC activation.
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connectivity among patients with mental disorders who Chavez and Heatherton et al. found that with increased
experience SS. self-esteem, functional connectivity between the medial
PFC and the bilateral striata also increased, enhancing
Research using rs-fMRI has found that changes in resistance to negative information. Onoda et al. found
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functional connectivity between the superficial-calcarine that low self-esteem may be related to the functional
cortex are related to responses to anti-stigma interventions. connectivity between the left primary motor cortex and
However, there is no significant association between the right superior parietal lobule and that individuals with
changes in amygdala-PFC functional connectivity and low self-esteem exhibited more activity in the dorsal ACC.
changes in stigma. In a study on low self-esteem and self- Fertuck et al. reported decreased activation in the vmPFC
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blame, Pan et al. found that decreased self-esteem was of patients with borderline personality disorder when
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associated with reduced functional connectivity between facing social exclusion.
the left vmPFC and the bilateral hippocampi, while
functional connectivity between the left vmPFC and the The aforementioned rs-fMRI and tb-fMRI studies
right inferior frontal gyrus and superior temporal gyrus on SS and its related factors indicate that the emergence
was negatively correlated with self-esteem. Jiang et al. of SS, low self-esteem, and self-blame are directly related
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found that low self-esteem led to increased activation in to the functional connectivity state of the PFC and other
the right dorsolateral PFC and bilateral thalami. Jaeckle brain regions or the activation intensity of the PFC itself.
et al. discovered that patients with depression who This may be because the activity in the medial PFC is the
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exhibited self-blame had significantly increased functional basis for self-related cognitive activities. In addition, the
connectivity between the right superior temporal gyrus activation levels of brain regions such as the amygdala,

Volume 3 Issue 4 (2025) 5 doi: 10.36922/jcbp.8413