18/8/2021 Altered empathy-related resting-state functional connectivity in patients with bipolar disorder | SpringerLink

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Original Paper Published: 19 July 2021

Altered empathy-related resting-state

functional connectivity in patients
with bipolar disorder
Yun-si Liang, Shu-zhe Zhou, Yi-jing Zhang, Xin-lu Cai, Yi
Wang, Eric F. C. Cheung, Simon S. Y. Lui, Xin Yu, Kristoffer
H. Madsen, Yan-tao Ma & Raymond C. K. Chan

European Archives of Psychiatry and Clinical Neuroscience

(2021)
130 Accesses 14 Altmetric Metrics

Abstract

Empathy is the ability to generate emotional

responses (i.e., cognitive empathy) and to make
cognitive inferences (i.e., affective empathy) to
other people’s emotions. Empirical evidence
suggests that patients with bipolar disorder (BD)
exhibit impairment in cognitive empathy, but
findings on affective empathy are inconsistent. Few
studies have examined the neural mechanisms of
cognitive and affective empathy in patients with
BD. In this study, we examined the empathy-
related resting-state functional connectivity (rsFC)
in BD patients. Thirty-seven patients with BD and
42 healthy controls completed the self-report
Questionnaires of Cognitive and Affective Empathy
(QCAE), the Yoni behavioural task, and resting-sate
fMRI brain scans. Group comparison of empathic
ability was conducted. The interactions between
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18/8/2021 Altered empathy-related resting-state functional connectivity in patients with bipolar disorder | SpringerLink

group and empathic ability on seed-based whole

brain rsFC were examined. BD patients scored
lower on the Online Simulation subscale of the
QCAE and showed positive correlations between
cognitive empathy and the rsFC of the dorsal
Medial Prefrontal Cortex (dmPFC) with the lingual
gyrus. The correlations between cognitive empathy
and the rsFC of the temporal–parietal junction
(TPJ) with the fusiform gyrus, the cerebellum and
the parahippocampus were weaker in BD patients
than that in healthy controls. These findings
highlight the underlying neural mechanisms of
empathy impairments in BD patients.

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Acknowledgements

This study was supported by grants from Beijing

Municipal Science & Technology Commission
Grant (Z161100000216138), Beijing Training
Project for the Leading Talents in Science and
Technology (Z151100000315020), Beijing
Municipal Science and Technology Commission
(Z171100001017086), National Natural Science
Foundation of China (31871114; 31400884), and
the CAS Key Laboratory of Mental Health, Institute
of Psychology. These funding agents had no further
role in the study design; in the collection, analysis
and interpretation of the data; in the writing of the
manuscript; and in the decision to submit the paper
for publication.

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Author information

1. Yun-si Liang and Shu-zhe Zhou equally

contributed to this article.

Affiliations

1. Neuropsychology and Applied Cognitive

Neuroscience Laboratory, CAS Key Laboratory
of Mental Health, Institute of Psychology,
Chinese Academy of Sciences, 16 Lincui Road,
Chaoyang District, Beijing, 100101, China

Yun-si Liang, Yi-jing Zhang, Xin-lu Cai, Yi

Wang & Raymond C. K. Chan

2. Sino-Danish College, University of Chinese

Academy of Sciences, Beijing, China

Yun-si Liang, Xin-lu Cai & Raymond C. K.

Chan

3. Sino-Danish Center for Education and

Research, Beijing, China

Yun-si Liang, Xin-lu Cai, Kristoffer H.

Madsen & Raymond C. K. Chan

4. Department of Psychology, University of

Chinese Academy of Sciences, Beijing, China

Yun-si Liang, Yi-jing Zhang, Xin-lu Cai, Yi

Wang & Raymond C. K. Chan

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18/8/2021 Altered empathy-related resting-state functional connectivity in patients with bipolar disorder | SpringerLink

5. Peking University Sixth Hospital, 51 Huayuan

Road, Haidian District, Beijing, 100191, China

Shu-zhe Zhou, Xin Yu & Yan-tao Ma

6. Peking University Institute of Mental Health,

Beijing, China

Shu-zhe Zhou, Xin Yu & Yan-tao Ma

7. Key Laboratory of Mental Health, Ministry of

Health, Peking University, Beijing, China

Shu-zhe Zhou, Xin Yu & Yan-tao Ma

8. National Clinical Research Center for Mental

Disorders, Peking University Sixth Hospital,
Beijing, China

Shu-zhe Zhou, Xin Yu & Yan-tao Ma

9. Castle Peak Hospital, Hong Kong Special

Administrative Region, Hong Kong, China

Eric F. C. Cheung & Simon S. Y. Lui

10. Department of Psychiatry, The University of

Hong Kong, Hong Kong Special
Administrative Region, Hong Kong, China

Simon S. Y. Lui

11. Danish Research Centre for Magnetic

Resonance, Centre for Functional and

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18/8/2021 Altered empathy-related resting-state functional connectivity in patients with bipolar disorder | SpringerLink

Diagnostic Imaging and Research,

Copenhagen University Hospital, Amager and
Hvidovre, Hvidovre, Denmark

Kristoffer H. Madsen

12. Department of Applied Mathematics and

Computer Science, Technical University of
Denmark, Kongens Lyngby, Denmark

Kristoffer H. Madsen

Contributions

YL collected and analyzed the data, and wrote up

the draft of the manuscript. SZ was responsible for
imaging data protocol, collection and quality
control, helped analyzed the data and interpreted
the findings and commented the draft critically. YZ
and XC collected data and implanted test, and
commented on the manuscript critically. YW
designed the study, contributed to imaging data
analysis, quality control, interpreted the findings
and commented critically on the manuscript. YM
contributed to the funding sources, monitoring the
clinical data quality, interpreted the findings and
commented on the manuscript critically. EC, SL,
KM and XY interpreted the findings and
commented on the manuscript critically. RC
generated the idea and designed the study,
interpreted the findings and commented on the
manuscript critically. All authors commented on
the manuscript and agreed to the final submission.

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Corresponding authors

Correspondence to Yan-tao Ma or Raymond C. K.

Chan.

Ethics declarations

Conflict of interest

The authors declared that there are no conflicts of

interest in relation to the subject of this study.

Supplementary Information

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Cite this article

Liang, Ys., Zhou, Sz., Zhang, Yj. et al. Altered

empathy-related resting-state functional
connectivity in patients with bipolar disorder. Eur
Arch Psychiatry Clin Neurosci (2021).
https://doi.org/10.1007/s00406-021-01305-4

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18/8/2021 Altered empathy-related resting-state functional connectivity in patients with bipolar disorder | SpringerLink

Received22 December 2020

Accepted12 July 2021

Published19 July 2021

DOIhttps://doi.org/10.1007/s00406-021-
01305-4

Keywords

Cognitive empathy
Affective empathy
Theory of mind
Bipolar disorder
Resting-state functional connectivity

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