Abstract
Empathetic verbal feedback from others has been shown to alleviate the intensity of experimental pain. To investigate the brain changes associated with this effect, we conducted 3T-fMRI measurements in 30 healthy subjects who received painful thermal stimuli on their left hand while overhearing empathetic, neutral or unempathetic comments, supposedly made by experimenters, via headsets. Only the empathetic comments significantly reduced pain intensity ratings. A whole-brain BOLD analysis revealed that both Empathetic and Unempathetic conditions significantly increased the activation of the right anterior insular and posterior parietal cortices to pain stimuli, while activations in the posterior cingulate cortex and precuneus (PCC/Prec) were significantly stronger during Empathetic compared to Unempathetic condition. BOLD activity increased in the DLPFC in the Empathetic condition and decreased in the PCC/Prec and vmPFC in the Unempathetic condition. In the Empathetic condition only, functional connectivity increased significantly between the vmPFC and the insular cortex. These results suggest that modulation of pain perception by empathetic feedback involves a set of high-order brain regions associated with autobiographical memories and self-awareness, and relies on interactions between such supra-modal structures and key nodes of the pain system.
Highlights
Humans have the capacity to estimate each others’ pain and to provide adapted care in order to reduce it
We hypothesised that brain areas (i) responding to “safety”; (ii) implicated in self-regulatory processes and (iii) contextual processing would be involved in the cerebral mechanisms related to the reappraisal of pain perception by others’ empathetic comments
Brain activity related to experimenters’ comments, thermal noxious stimuli, and fluctuation of pain intensity perception were examined for the whole functional magnetic resonance imaging (fMRI) experiment (Fig. 1a) across all the conditions, and thresholded at p < 0.01 corrected
Summary
Humans have the capacity to estimate each others’ pain and to provide adapted care in order to reduce it. Brain activity associated with pain reduction in these conditions was found in areas responding to “safety” (i.e., the ventromedial prefrontal cortex and the posterior cingulate cortex)[18] and self-regulatory processes (i.e., dorsolateral prefrontal cortex)[20]. Since the pain experience results from the interaction of sensory brain areas with higher-order brain networks[9,10,23], we postulated that empathetic feedback would modulate pain-related responses through changes in these high-level brain areas associated with inferring and representing states of self and other awareness[24]. We hypothesised that brain areas (i) responding to “safety” (i.e., the ventromedial prefrontal cortex and the posterior cingulate cortex); (ii) implicated in self-regulatory processes (i.e., dorsolateral prefrontal cortex) and (iii) contextual processing (i.e., anterior insula) would be involved in the cerebral mechanisms related to the reappraisal of pain perception by others’ empathetic comments
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