Page 12 - JCBP-3-4

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

thalamus, and ACC have potential associations with SS used by the patients and inadequate sample size. Jollant
and its related factors (Table 2). et al. reported that, compared to BD patients without
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suicidal ideation, BD patients with suicidal ideation
3.2. Research progress of MRS in SS
had increased Cho/Cr ratio in the right hippocampus,
Among the negative consequences arising from SS increased NAA/Cr ratio in the bilateral PWM, increased
are low self-esteem and increased suicide risk among mI/Cr ratio in the right PWM, and decreased NAA/
individuals with mental disorders. Similarly, low self- Cr ratio in the left hippocampus. In previous studies,
esteem can also elevate the risk of suicide, making SS psychological distress was highly correlated with
and low self-esteem intermediary variables in suicides suicidal ideation. One study found that decreased NAA
among patients with mental disorders. 46,48,62 The levels in the right dorsolateral PFC were associated with
disclosure of suicidal thoughts and behaviors has a psychological distress, while increased Gln levels in the
negative impact on SS, reducing the likelihood of such right dorsolateral PFC were associated with suicidal
individuals seeking help. 63,64 A study by Lewis et al. 68
65
found increased Glx and decreased NAA in the ACC of ideation. However, there was no significant difference
adolescent patients with suicidal ideation or behavior, in the NAA/Cr ratio in the PFC between BD patients
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as well as decreased NAA/Glx ratio in the ACC of with and without suicidal ideation. Suicidal ideation
adolescents with suicidal ideation. Another study found or behavior can lead to the emergence of suicide stigma,
an association between suicidal behavior and increased which increases SS. Therefore, SS may potentially
mI in the ACC, but no association between suicidal influence changes in neurometabolic levels caused by
behavior and NAA was identified. The differences in suicidal ideation or behavior, providing a basis and
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NAA levels in the ACC observed in these two studies may research direction for neurometabolic disturbances
be related to factors such as differences in medications caused by SS (Table 2).

Table 2. The main findings of functional magnetic resonance imaging on self‑stigma

Authors Year Comparison objects=sample Imaging methods Main findings
size
Nakamura 2020 Healthy young adults=77 rs-fMRI In a 12-month intervention for stigma in healthy people with
et al. 49 schizophrenia, it was found that in the filmed social contacts group,
the stigma scores decreased, and the functional connectivity in the
superficial subregion-calcium endothelial layer increased.
Lem et al. 53 2023 40 participants rs-fMRI The immersive virtual reality interventions reduced stigma. Depression
knowledge score was positively correlated with functional connectivity
activated in the right superior frontal gyrus.
Raij et al. 47 2014 Schizophrenia=20; HC=16 tb-fMRI The strength of the association between schizophrenia and social
disadvantage was negatively correlated with the intensity of activation
in the rostral ventral mPFC in schizophrenic patients. The intensity
of mPFC activation was negatively correlated with the intensity of
amygdala activation.
Welborn et al. 55 2020 40 participants tb-fMRI During the anticipation of incentive measures, negative stereotypes can
affect the internal functional connectivity of the nucleus accumbens.
Machine learning analysis indicated that the connection patterns
between the nucleus accumbens and reward-related brain regions were
influenced by stereotypes.
Krendl et al. 57 2012 Healthy adults=20 tb-fMRI The functional connectivity of the ACC, as well as the lateral and
mPFC, was increased when regulating feelings of stigma. In addition,
compared to typical emotion regulation, there was greater activation
in the PFC.
Chen et al. 67 2022 BD with suicidal ideation=32; 1 H-MRS The significant indicators for distinguishing between BD patients with
BD without suicidal ideation=18 and without suicidal ideation include the ratios of NAA/Cr and mI/Cr
in the bilateral PWM, NAA/Cr and Cho/Cr in the left hippocampus,
and Cho/Cr in the right hippocampus.
Abbreviations: H-MRS: Proton magnetic resonance spectroscopy; ACC: Anterior cingulate cortex; BD: Bipolar disorder; Cho: Choline; Cr: Creatine;
1
mI: Myo-inositol; mPFC: Medial prefrontal cortex; NAA: N-acetylaspartate; PFC: Prefrontal cortex; PWM: Prefrontal white matter; rs-fMRI:
Resting-state functional magnetic resonance imaging; tb-fMRI: Task-based functional magnetic resonance imaging.

Volume 3 Issue 4 (2025) 6 doi: 10.36922/jcbp.8413