Abstract
The ability to perceive and feel another person' pain as if it were one's own pain, e.g., pain empathy, is related to brain activity in the “pain-matrix” network. A non-core region of this network in Dorsolateral Prefrontal Cortex (DLPFC) has been suggested as a modulator of the attentional-cognitive dimensions of pain processing in the context of pain empathy. We conducted a neurofeedback experiment using real-time functional magnetic resonance imaging (rt-fMRI-NF) to investigate the association between activity in the left DLPFC (our neurofeedback target area) and the perspective assumed by the participant (“first-person”/“Self” or “third-person”/“Other” perspective of a pain-inducing stimulus), based on a customized pain empathy task. Our main goals were to assess the participants' ability to volitionally modulate activity in their own DLPFC through an imagery task of pain empathy and to investigate into which extent this ability depends on feedback. Our results demonstrate participants' ability to significantly modulate brain activity of the neurofeedback target area for the “first-person”/”Self” and “third-person”/”Other” perspectives. Results of both perspectives show that the participants were able to modulate (with statistical significance) the activity already in the first run of the session, in spite of being naïve to the task and even in the absence of feedback information. Moreover, they improved modulation throughout the session, particularly in the “Self” perspective. These results provide new insights on the role of DLPFC in pain and pain empathy mechanisms and validate the proposed protocol, paving the way for future interventional studies in clinical populations with empathic deficits.
Highlights
Pain is one of the most used processes to invoke empathy
The “Other” perspective, as an example of perspective taking, involves the activation of the precuneus, temporoparietal junction (TPJ), superior temporal sulcus (STS), middle temporal gyrus, middle frontal gyrus, and prefrontal cortex, a network of regions previously identified in ToM studies [9,10,11,12,13,14]
There is a gap in the current literature regarding rtfMRI-NF studies that focus on pain empathy
Summary
Pain is one of the most used processes to invoke empathy. Imagining oneself (“first-person”/”Self ” perspective) or another person (“third-person”/”Other” perspective) in painful situations encompasses a process of perspective taking which, in turn, is a stepping stone to human empathy—the capacity to share and understand the emotional states of others [1,2,3,4]. The shared pain network between pain nociception and vicarious pain experience comprises parts of the pain matrix— the neural network responsible for experiencing pain [7,8,9,10] This network comprehends an affective-motivational (including anterior cingulate/midcingulate cortices—ACC/MCC, and anterior insula—AI) and a sensory-discriminative (including somatosensory cortices—S1 and S2) components. One’s ability to take the perspective of others and understand their emotions (Theory of Mind, ToM) is strongly related with empathy for pain [15, 16] In this sense, the “Other” perspective, as an example of perspective taking, involves the activation of the precuneus, temporoparietal junction (TPJ), superior temporal sulcus (STS), middle temporal gyrus, middle frontal gyrus, and prefrontal cortex, a network of regions previously identified in ToM studies [9,10,11,12,13,14]
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