Abstract
Empathy is an essential component of our social lives, allowing us to understand and share other people's affective and sensory states, including pain. Evidence suggests a core neural network—including anterior insula (AI) and mid-cingulate cortex (MCC)—is involved in empathy for pain. However, a similar network is associated to empathy for non-pain affective states, raising the question whether empathy for pain is unique in its neural correlates. Furthermore, it is yet unclear whether neural correlates converge across different stimuli and paradigms that evoke pain-empathy. We performed a coordinate-based activation likelihood estimation (ALE) meta-analysis to identify neural correlates of empathy, assess commonalities and differences between empathy for pain and for non-pain negative affective states, and differences between pain-empathy evoking stimuli (i.e., facial pain expressions vs. acute pain inflictions) and paradigms (i.e., perceptual/affective vs. cognitive/evaluative paradigms). Following a systematic search, data from 128 functional brain imaging studies presenting whole-brain results of an empathy condition vs. baseline/neutral condition were extracted. Synthesizing neural correlates of empathy confirmed a core network comprising AI, MCC, postcentral gyrus, inferior parietal lobe, thalamus, amygdala, and brainstem. There was considerable overlap in networks for empathy for pain and empathy for non-pain negative affective states. Important differences also arose: empathy for pain uniquely activated bilateral mid-insula and more extensive MCC. Regarding stimuli, painful faces and acute pain inflictions both evoked the core empathy regions, although acute pain inflictions activated additional regions including medial frontal and parietal cortex. Regarding paradigms, both perceptual/affective and cognitive/evaluative paradigms recruited similar neural circuitry, although cognitive/evaluative paradigms activated more left MCC regions while perceptual/affective paradigms activated more right AI. Taken together, our findings reveal that empathy for pain and empathy for non-pain negative affective states share considerable neural correlates, particularly in core empathy regions AI and MCC. Beyond these regions, important differences emerged, limiting generalizability of findings across different affective/sensory states. Within pain-empathy studies, the core regions were recruited robustly irrespective of stimuli or instructions, allowing one to tailor designs according to specific needs to some extent, while ensuring activation of core regions.
Highlights
Empathy is an essential part of being a social organism
We performed a metaanalysis of functional brain imaging studies of empathy to both replicate previous findings of a core empathy neural network and to identify whether neural correlates of empathy for pain are unique and distinct from those of empathy for non-pain negative affective states
These regions are recruited robustly, irrespective of the affective state of the observed, of the type of stimuli, and of the instructions. To some extent this allows one to tailor the paradigm and stimuli within an empathy study to a specific context. These core regions do not act in isolation; rather, they interact with many other brain regions
Summary
Empathy is an essential part of being a social organism. It allows one to understand and share emotions and promotes prosocial behavior (Davis, 1994; Preston and De Waal, 2002; Singer and Lamm, 2009; Zaki, 2014; Decety et al, 2016). There are different views on the core components of empathy, there is some agreement that it involves (1) awareness and understanding of the other person’s emotions This part is similar to mentalizing and theory of mind, where one is explicitly making sense of another person’s affective state or beliefs/intentions (Leslie et al, 2004); (2) distinction between the other person and the self; and (3) sharing of the other person’s affective state (similar, but distinct from emotional contagion, which refers to the catching and automatic mimicking of other people’s emotions; Hatfield et al, 1993). Some argue that empathy comprises feelings of compassion or sympathy ( referred to as empathic care/concern) and the prosocial motivation to help the other person (see Singer and Lamm, 2009; Zaki and Ochsner, 2012, for more discussion)
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