1.The Relationship Between Brain Activation for Taking Others’ Perspective and Interoceptive Abilities in Autism Spectrum Disorder: An fMRI Study
Huiyeong JEON ; Ahjeong HUR ; Hoyeon LEE ; Yong-Wook SHIN ; Sang-Ick LEE ; Chul-Jin SHIN ; Siekyeong KIM ; Gawon JU ; Jeonghwan LEE ; Joon Hyung JUNG ; Seungwon CHUNG ; Jung-Woo SON
Journal of the Korean Academy of Child and Adolescent Psychiatry 2024;35(3):197-209
Objectives:
In this functional magnetic resonance imaging study, we aimed to investigate the differences in brain activation between individuals with autism spectrum disorder (ASD) and typically developing (TD) individuals during perspective taking. We also examined the association between brain activation and empathic and interoceptive abilities.
Methods:
During scanning, participants from the ASD (n=17) and TD (n=22) groups were shown pain stimuli and asked to rate the level of the observed pain from both self- and other-perspectives. Empathic abilities, including perspective taking, were measured using an empathic questionnaire, and three dimensions of interoception were assessed: interoceptive accuracy, interoceptive sensibility, and interoceptive trait prediction errors.
Results:
During self-perspective taking, the ASD group exhibited greater activation in the left precuneus than the TD group. During other-perspective taking, relative hyperactivation extended to areas including the right precuneus, right superior frontal gyrus, left caudate nucleus, and left amygdala. Brain activation levels in the right superior frontal gyrus while taking other-perspective were negatively correlated with interoceptive accuracy, and those in the left caudate were negatively correlated with perspective taking ability in the ASD group.
Conclusion
Individuals with ASD show atypical brain activation during perspective taking. Notably, their brain regions associated with stress reactions and escape responses are overactivated when taking other-perspective. This overactivity is related to poor interoceptive accuracy, suggesting that individuals with ASD may experience difficulties with the self-other distinction or atypical embodiment when considering another person’s perspective.
2.Graph Theoretical Analysis of Brain Structural Connectivity in Patients with Alcohol Dependence
Hyunjung LEE ; Joon Hyung JUNG ; Seungwon CHUNG ; Gawon JU ; Siekyeong KIM ; Jung-Woo SON ; Chul-Jin SHIN ; Sang Ick LEE ; Jeonghwan LEE
Experimental Neurobiology 2023;32(5):362-369
This study aimed to compare brain structural connectivity using graph theory between patients with alcohol dependence and social drinkers. The participants were divided into two groups; the alcohol group (N=23) consisting of patients who had been hospitalized and had abstained from alcohol for at least three months and the control group (N=22) recruited through advertisements and were social drinkers. All participants were evaluated using 3T magnetic resonance imaging. A total of 1000 repeated whole-brain tractographies with random parameters were performed using DSI Studio. Four hundred functionally defined cortical regions of interest (ROIs) were parcellated using FreeSurfer based on the Schaefer Atlas.The ROIs were overlaid on the tractography results to generate 1000 structural connectivity matrices per person, and 1000 matrices were averaged into a single matrix per subject. Graph analysis was performed through igraph R package. Graph measures were compared between the two groups using analysis of covariance, considering the effects of age and smoking pack years. The alcohol group showed lower local efficiency than the control group in the whole-brain (F=5.824, p=0.020), somato-motor (F=5.963, p=0.019), and default mode networks (F=4.422, p=0.042). The alcohol group showed a lower global efficiency (F=5.736, p=0.021) in the control network. The transitivity of the alcohol group in the dorsal attention network was higher than that of the control (F=4.257, p=0.046). Our results imply that structural stability of the whole-brain network is affected in patients with alcohol dependence, which can lead to ineffective information processing in cases of local node failure.
3.The Relationship Between Anger and Suicidality
Jun-Hyuck KIM ; Gawon JU ; Sang Ick LEE ; Chul-Jin SHIN ; Jung-Woo SON ; Siekyeong KIM ; Jeonghwan LEE ; Seungwon CHUNG
Mood and Emotion 2023;21(3):86-94
Background:
This study explored the effect of anger on suicidality by dividing participants into a group with major depressive disorder (MDD) and a non-MDD group, and also investigated whether the anger expression affects suicidality in participants without clinical depression.
Methods:
A total of 1,015 residents responded to anonymous questionnaires in our survey. The survey included scales, such as the Patients Health Questionnaire-9 (PHQ-9), Korean State-Trait Anger Expression Inventory, and Mini-International Neuropsychiatric Interview-Plus. Participants were categorized into the MDD and non-MDD groups or depression group and non-depression group following the PHQ-9 score. Logistic regression analysis was performed to confirm the association between anger and suicidality in the non-MDD and non-MDD groups.
Results:
Anger suppression and higher PHQ-9 appeared as risk factors for suicidality in the non-MDD group. The depression level in the non-MDD group mediates the relationship between anger suppression and suicidality. Higher PHQ-9 was no longer a risk factor and anger suppression remains a risk factor in the non-depression group.
Conclusion
Not only depression evaluation, but also anger evaluation is important when assessing suicidality. Implementing anger management programs for people with high anger suppression can help lower suicidality in Korean society, where negative emotional expression is suppressed.
4.Preliminary Comparison of Subcortical Structures in Elderly Subclinical Depression: Structural Analysis with 3T MRI
SangJin IM ; Jeonghwan LEE ; Siekyeong KIM
Experimental Neurobiology 2021;30(2):183-202
Depression in the elderly population has shown increased likelihood of neurological disorders due to structural changes in the subcortical area. However, further investigation into depression related subcortical changes is needed due to mismatches in structural analysis results between studies as well as scarcities in research regarding subcortical connectivity patterns of subclinical depression populations. This study aims to investigate structural differences in subcortical regions of aged participants with subclinical depression using 3Tesla MRI. In structural analysis, volumes of each subcortical region were measured to observe the volumetric difference and asymmetry between groups, but no significant difference was found. In addition, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) did not show any significant differences between groups.Structural analysis using probabilistic tractography indicated that the connection strength between left nucleus accumbens-right hippocampus, and right thalamus-right caudate was higher in the control group than the subclinical depression group. The differences in subcortical connection strength of subclinical depression groups, have shown to correlate with emotional and cognitive disorders, such as anxiety and memory impairment. We believe that the analysis of structural differences and cross-regional network measures in subcortical structures can help identify neurophysiological changes occurring in subclinical depression.
5.Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder
Jeonghwan LEE ; Jung-Woo SON ; Siekyeong KIM ; Ji-eun KIM ; Seungwon CHUNG ; Hei-Rhee GHIM ; Sang-Ick LEE ; Chul-Jin SHIN ; Gawon JU
Journal of the Korean Academy of Child and Adolescent Psychiatry 2021;32(4):129-136
Objectives:
To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD).
Methods:
Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer.
Results:
Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group.
Conclusion
The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.
6.Preliminary Comparison of Subcortical Structures in Elderly Subclinical Depression: Structural Analysis with 3T MRI
SangJin IM ; Jeonghwan LEE ; Siekyeong KIM
Experimental Neurobiology 2021;30(2):183-202
Depression in the elderly population has shown increased likelihood of neurological disorders due to structural changes in the subcortical area. However, further investigation into depression related subcortical changes is needed due to mismatches in structural analysis results between studies as well as scarcities in research regarding subcortical connectivity patterns of subclinical depression populations. This study aims to investigate structural differences in subcortical regions of aged participants with subclinical depression using 3Tesla MRI. In structural analysis, volumes of each subcortical region were measured to observe the volumetric difference and asymmetry between groups, but no significant difference was found. In addition, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) did not show any significant differences between groups.Structural analysis using probabilistic tractography indicated that the connection strength between left nucleus accumbens-right hippocampus, and right thalamus-right caudate was higher in the control group than the subclinical depression group. The differences in subcortical connection strength of subclinical depression groups, have shown to correlate with emotional and cognitive disorders, such as anxiety and memory impairment. We believe that the analysis of structural differences and cross-regional network measures in subcortical structures can help identify neurophysiological changes occurring in subclinical depression.
7.Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder
Jeonghwan LEE ; Jung-Woo SON ; Siekyeong KIM ; Ji-eun KIM ; Seungwon CHUNG ; Hei-Rhee GHIM ; Sang-Ick LEE ; Chul-Jin SHIN ; Gawon JU
Journal of the Korean Academy of Child and Adolescent Psychiatry 2021;32(4):129-136
Objectives:
To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD).
Methods:
Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer.
Results:
Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group.
Conclusion
The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.
8.Cognitive and Emotional Empathy in Young Adolescents: an fMRI Study
Eun Jin KIM ; Jung-Woo SON ; Seong Kyoung PARK ; Seungwon CHUNG ; Hei-Rhee GHIM ; Seungbok LEE ; Sang-Ick LEE ; Chul-Jin SHIN ; Siekyeong KIM ; Gawon JU ; Hyemi PARK ; Jeonghwan LEE
Journal of the Korean Academy of Child and Adolescent Psychiatry 2020;31(3):121-130
Objectives:
We investigated the differences in cognitive and emotional empathic ability between adolescents and adults, and the differences of the brain activation during cognitive and emotional empathy tasks.
Methods:
Adolescents (aged 13–15 years, n=14) and adults (aged 19–29 years, n=17) completed a range of empathic ability questionnaires and were scanned functional magnetic resonance imaging (fMRI) during both cognitive and emotional empathy task. Differences in empathic ability and brain activation between the groups were analyzed.
Results:
Both cognitive and emotional empathic ability were significantly lower in the adolescent compared to the adult group. Comparing the adolescent to the adult group showed that brain activation was significantly greater in the right transverse temporal gyrus (BA 41), right insula (BA 13), right superior parietal lobule (BA 7), right precentral gyrus (BA 4), and right thalamus whilst performing emotional empathy tasks. No brain regions showed significantly greater activation in the adolescent compared to the adult group while performing cognitive empathy task. In the adolescent group, scores of the Fantasy Subscale in the Interpersonal Reactivity Index, which reflects cognitive empathic ability, negatively correlated with activity of right superior parietal lobule during emotional empathic situations (r=-0.739, p=0.006).
Conclusion
These results strongly suggest that adolescents possess lower cognitive and emotional empathic abilities than adults do and require compensatory hyperactivation of the brain regions associated with emotional empathy or embodiment in emotional empathic situation. Compensatory hyperactivation in the emotional empathy-related brain areas among adolescents are likely associated with their lower cognitive empathic ability.
9.Atrophy of Thalamic Nuclei in Patients with Alcohol Dependence
Jeonghwan LEE ; Seungwon CHUNG ; Hyemi PARK ; Gawon JU ; Jung-Woo SON ; Chul-Jin SHIN ; Sang Ick LEE ; Siekyeong KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2020;26(3):259-268
Objectives:
:Chronic alcohol ingestion is associated with structural alterations in the brain. In patients with alcohol dependence, thalamic volume is frequently diminished, commensurate with the amount of alcohol consumption, duration of illness, and cognitive impairment. Since the thalamus is composed of histologically and functionally distinct nuclei, we aimed to investigate volumetric changes of these nuclei in patients with alcohol dependence.
Methods:
:Twenty-three participants with alcohol dependence who had abstained from drinking for at least 3 months (alcohol group) and 21 age-matched healthy controls (control group) underwent 3T magnetic resonance imaging. The volumes of 50 individual thalamic nuclei were reconstructed using FreeSurfer 6.0.0. We compared normalized volumes of thalamic nuclei between the two groups using analysis of covariance, controlling for age. The p-values were corrected using False Discovery Rate (p<0.05).
Results:
:The alcohol group demonstrated atrophy of the whole thalamus and nuclei in the anterior, ventral, intralaminar, and medial thalamus. However, the volumes of bilateral lateral geniculate, medial geniculate, suprageniculatelimitans, pulvinar lateral, and right pulvinar inferior nuclei which are included in posterior thalamus, were not significantly different between the two groups.
Conclusion
:In the alcohol group, atrophy of most thalamic nuclei which are associated with language processing, visuospatial memory, autobiographical memory, executive function and attention were not normalized after 3 months of sobriety. Furthermore, thalamic nuclei volumes, which are associated with visual and auditory information processing, were not significantly different compared to controls. We suggest that this could be microstructural evidence of relatively preserved visual attention and auditory startle response in patients with alcohol dependence.
10.The Relationship between Insomnia and Somatization According to Types of Work of Firefighters
Heesoo YOON ; Gawon JU ; Sang Ick LEE ; Chul-Jin SHIN ; Jung-Woo SON ; Siekyeong KIM ; Hyemi PARK ; Jeong Hwan LEE
Korean Journal of Psychosomatic Medicine 2020;28(1):42-52
Objectives:
:Firefighters are always under stress due to their job environment, and they are likely to become psychologically vulnerable due to continuous exposure to traumatic events, which is a stressful situation that requires emergency standby at all times. The aims of this study were to examine mental health factors for each division of firefighters and to see the relationship between sleep and somatization symptoms among them.
Methods:
:General characteristics and related inspections were conducted through self-reporting questionnaires for 1,264 firefighters working at Chungbuk fire stations. Several mental health factors were investigated by the Insomnia Severity Index, Severity of somatic symptoms, Impact of Event Scale, Perceived Stress Scale, Resilience Scale, Alcohol Dependent Screening Scale, and the Center for Epidemiologic Studies Depression Scale Depression Scale and Mini-International Neuropsychiatric Interview.
Results:
:Among the mental health variables, the relationship between insomnia and somatization varies significantly depending on types of work. It was reported that the first aid team was significantly higher than the fire suppression and rescue team. Post-traumatic stress, depression and drinking also differ significantly depending on types of work. The first aid team reported more posttraumatic stress than the fire suppression team and more depressed mood than the rescue team. The administration part had more alcohol consumption than the fire suppression or first aid team. Resilience was significantly higher in the rescue team than the first aid team. No significant differences between the types of work about stress and suicide risks. Insomnia, stress, and post-traumatic stress were significant predictors of somatization among firefighters. Above all, insomnia was significant mental health variable affecting somatization.
Conclusions
:Various mental health factors were different according to the types of work in firefighters. The First aid team was more vulnerable to mental health variables such as insomnia and somatization than other divisions. Insomnia is the most important cause of somatization in firefighters, so it is recommended that they be treated for insomnia and to prepare institutional policies.

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