2026 ECNP Congress

PS01-1146

A study on the brain activation related to cognitive empathy and emotional empathy in adolescent ADHD patients

Jungwoo Son — J.E. Kim · Chungbuk National University Hospital, Psychiatry, Cheongju, Korea- Rep

2026 ECNP Congress

Objective: Many studies have attempted to characterize ADHD. However, only a few focused on the empathic ability of adolescent ADHD. Recent evidence supposed that there are two systems for empathy: cognitive and emotional. Cognitive empathy is the capacity to infer other’s mental state including their thoughts or affect. On the other hand, emotional empathy is the capacity to respond with an appropriate emotion to another’s emotional state. It is supposed to be based on emotional contagion or feeling empathy for other’s in pain. The purpose of this study was to investigate the difference of psychological aspects and brain activity between adolescents with and without ADHD during cognitive and emotional empathy tasks.

Methods: Sixteen adolescents who were diagnosed with ADHD and nineteen carefully matched healthy adolescents without ADHD were scanned with functional MRI during an empathy task. Differences in brain activation between adolescents with and without ADHD were assessed by contrasting neural activation during a cognitive empathy task and an emotional empathy task. The ADHD-Rating Scale, Bryant’s Empathy Index and the children’s version of the empathy quotient were also used for behavioral and psychological measurement.

Results: According to the behavioral and psychological results, there were no difference in age, gender, or IQ between the two groups. However, adolescents with ADHD showed significantly higher scores on the ADHD-Rating Scale and lower scores on the cognitive empathy component of Bryant’s Empathy Index and the children’s version of the empathy quotient than those of adolescents without ADHD. In fMRI analyses, the results were as follows; (1) In analyses within-group, both groups exhibited brain activation in the cerebellum, posterior superior temporal sulcus, occipital gyrus, superior frontal gyrus (Brodmann area 6) during the cognitive empathy task, whereas the inferior frontal gyrus, and superior frontal gyrus (Brodmann area 6) were activated during the emotional empathy task. (2) In analyses between-groups, adolescents with ADHD exhibited greater brain activation than adolescents without ADHD in the bilateral superior frontal gyrus (Brodmann area 6), right orbitofrontal cortex (Brodmann area 11), right middle frontal gyrus (Brodmann area 6), and right medial prefrontal cortex (Brodmann area 9) during the cognitive empathy task. On the other hand, no differences between two groups in brain activation during the emotional empathy task were found. (3) Through correlation analyses, cognitive empathy of all participants exhibited a negative correlation with the activation in the right orbitofrontal cortex (Brodmann area 11), right middle frontal gyrus, and right superior frontal gyrus (Brodmann area 6). Inattentiveness of adolescents with ADHD showed a positive correlation with the activation in the middle occipital gyrus (Brodmann area 19), the right caudate body, and the dorsomedial thalamus.

Conclusions: Psychological data indicated that adolescents with ADHD showed a lowered cognitive empathy. Brain activities of adolescents with ADHD were greater in the brain regions associated with the empathic system than in adolescents without ADHD during a cognitive empathy task. Taken together, it also suggest that adolescents with ADHD might have defects in neuropsychological aspects of cognitive empathy.

References

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