Boosting the Theory of Mind Network: Specific Psychotherapy Increases Neural Correlates of Affective Theory of Mind in Euthymic Bipolar Disorder

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Kristina Meyer - , Charité – Universitätsmedizin Berlin (Author)
  • Catherine Hindi Attar - , Charité – Universitätsmedizin Berlin (Author)
  • Jana Fiebig - , Charité – Universitätsmedizin Berlin (Author)
  • Thomas Stamm - , Charité – Universitätsmedizin Berlin, Brandenburg Medical School Theodor Fontane (Author)
  • Tyler R. Bassett - , University Hospital Carl Gustav Carus Dresden (Author)
  • Michael Bauer - , Department of Psychiatry and Psychotherapy (Author)
  • Udo Dannlowski - , University of Münster (Author)
  • Thomas Ethofer - , University of Tübingen (Author)
  • Irina Falkenberg - , University of Marburg (Author)
  • Andreas Jansen - , University of Marburg (Author)
  • Georg Juckel - , Ruhr University Bochum (Author)
  • Tilo Kircher - , University of Marburg (Author)
  • Christoph Mulert - , Justus Liebig University Giessen (Author)
  • Gregor Leicht - , University of Hamburg (Author)
  • Anne Rau - , University of Tübingen (Author)
  • Dirk Ritter - , Department of Psychiatry and Psychotherapy (Author)
  • Philipp Ritter - , Department of Psychiatry and Psychotherapy (Author)
  • Sarah Trost - , University of Göttingen, Universitäre Altersmedizin FELIX PLATTER (Author)
  • Christoph Vogelbacher - , University of Marburg (Author)
  • Henrik Walter - , Charité – Universitätsmedizin Berlin (Author)
  • Sarah Wolter - , University of Göttingen, Otto von Guericke University Magdeburg (Author)
  • Martin Hautzinger - , University of Tübingen (Author)
  • Felix Bermpohl - , Charité – Universitätsmedizin Berlin (Author)

Abstract

Background: In bipolar disorder, impaired affective theory of mind (aToM) performance and aberrant neural activation in the ToM brain network partly explain social functioning impairments. However, it is not yet known whether psychotherapy of bipolar disorder influences neuroimaging markers of aToM. Methods: In this study, conducted within the multicentric randomized controlled trial of the BipoLife consortium, patients with euthymic bipolar disorder underwent 2 group interventions over 6 months (mean = 28.45 weeks): 1) a specific, cognitive behavioral intervention (specific psychotherapeutic intervention [SEKT]) (n = 31) targeting impulse regulation, ToM, and social skills and 2) an emotion-focused intervention (FEST) (n = 28). To compare the effect of SEKT and FEST on neural correlates of aToM, patients performed an aToM task during functional magnetic resonance imaging before and after interventions (final functional magnetic resonance imaging sample of pre- and postcompleters, SEKT: n = 16; FEST: n = 17). Healthy control subjects (n = 32) were scanned twice with the same time interval. Because ToM was trained in SEKT, we expected an increased ToM network activation in SEKT relative to FEST postintervention. Results: Both treatments effectively stabilized patients’ euthymic state in terms of affective symptoms, life satisfaction, and global functioning. Confirming our expectations, SEKT patients showed increased neural activation within regions of the ToM network, bilateral temporoparietal junction, posterior cingulate cortex, and precuneus, whereas FEST patients did not. Conclusions: The stabilizing effect of SEKT on clinical outcomes went along with increased neural activation of the ToM network, while FEST possibly exerted its positive effect by other, yet unexplored routes.

Details

Original languageEnglish
Pages (from-to)572-580
Number of pages9
JournalBiological Psychiatry: Cognitive Neuroscience and Neuroimaging
Volume8
Issue number5
Publication statusPublished - May 2023
Peer-reviewedYes

External IDs

PubMed 36087699
ORCID /0000-0003-4286-5830/work/149796280
ORCID /0000-0002-2666-859X/work/149797556

Keywords

Keywords

  • Bipolar Disorder, Neural correlates of Psychotherapy, Social cognition, Theory of Mind, ToM network, fMRI