Picture Of Pain Research Articles

Altered Cortical Processing of Observed Pain in Patients With Fibromyalgia Syndrome

Fibromyalgia syndrome (FMS) is characterized by widespread chronic pain, fatigue, sleep disorders, and cognitive-emotional disturbance. Patients with FMS exhibit increased sensitivity to experimental pain and pain-related cues, as well as deficits in emotional regulation. The present study investigated the spatiotemporal patterns of brain activations for observed pain in 19 patients with FMS and 18 age-matched, healthy control individuals using event-related potential analysis. Patients with FMS attributed greater pain and unpleasantness to pain pictures, relative to healthy control participants. An augmented late positive potential (LPP) component (>500 milliseconds) was found in patients viewing both pain and nonpain pictures, and this amplitude difference in the LPP covaried with perceived unpleasantness of pictures. Mid-latency potentials (250–450 milliseconds) demonstrated similar amplitude increases of positive potentials in the FMS patient group. By contrast, the short-latency positive potential (140 milliseconds) was reduced in patients with FMS relative to healthy control participants. Results suggest amplitude increases to mid- to long-latency cortical activations in patients with FMS, which are known to reflect emotional control and motivational salience of stimuli. PerspectivePatients with FMS demonstrate increased activations associated with pain and nonpain pictures. The findings suggest that even innocuous, everyday visual stimuli with somatic connotations may challenge the emotional state of patients with FMS. Our study points toward the importance of cognitive-emotional therapeutic approaches for the treatment of FMS.

Lumbar Neural Foraminal Extradural Lipoma: Case Report, Literature Review

Introduction Extradural lipoma is a rare condition of which few cases have been described in the literature, and a low percentage of these appear in the lumbar spine. The purpose of our presentation is to describe a new case of this entity, to deepen understanding of the clinical and imaging findings of this condition as well as its treatment. Materials and Methods Retrospective study of a clinical case that arrived for consultation presenting a clinical picture of long-term lumbar pain for 2 years. For 9 months there was bilateral lumbosciatic pain, intermittently more severe on the right side, S1 sensory deficit right side. Clinical evaluation, physical examination, and imaging studies were performed. Results The following were evaluated: history, clinical picture, age, gender, type of images requested and their results, treatment undertaken, and time of evolution of the symptoms. A literature review of this condition was made, comparing what has been published with our experience. Conclusion The lumbar extradural spinal lipoma is a rare benign tumor lesion that can produce backache and neurological compression. When the patient consults because of the appearance of neurological disorders secondary to compression phenomena, MRI is the test of choice for the evaluation of this pathology. Recovery from the symptoms occurs in most cases after surgical decompression.

Pictures of pain: their contribution to the neuroscience of empathy.

The study of empathy, a translation of the term 'Einfühlung', originated in 19th century Germany in the sphere of aesthetics, and was followed by studies in psychology and then neuroscience. During the past decade the links between empathy and art have started to be investigated, but now from the neuroscientific perspective, and two different approaches have emerged. Recently, the primacy of the mirror neuron system and its association with automaticity and imitative, simulated movement has been envisaged. But earlier, a number of eminent art historians had pointed to the importance of cognitive responses to art; these responses might plausibly be subserved by alternative neural networks. Focusing here mainly on pictures depicting pain and evoking empathy, both approaches are considered by summarizing the evidence that either supports the involvement of the mirror neuron system, or alternatively suggests other neural networks are likely to be implicated. The use of such pictures in experimental studies exploring the underlying neural processes, however, raises a number of concerns, and suggests caution is exercised in drawing conclusions concerning the networks that might be engaged. These various networks are discussed next, taking into account the affective and sensory components of the pain experience, before concluding that both mirror neuron and alternative neural networks are likelyto be enlisted in the empathetic response to images of pain. A somewhat similar duality of spontaneous and cognitive processes may perhaps also be paralleled in the creation of such images. While noting that some have repudiated the neuroscientific approach to the subject, pictures are nevertheless shown here to represent an unusual but invaluable tool in the study of pain and empathy.

Perceiving one's body shapes empathy

BackgroundEmpathy is a basic human ability with affective and cognitive facets and high interindividual variability. Accurately detecting one's internal body signals (interoceptive sensitivity) strongly contributes to the awareness of oneself and is known to interact with emotional and cognitive processes. This study investigated whether interoceptive sensitivity (i.e., heartbeat perception task) shapes affective and cognitive empathy. MethodsNinety-three participants were asked to report the valence of their feelings, as well as the degree of compassion, arousal, and distress they felt in response to pictures depicting other people in pain or in non-pain situations. Participants also had to estimate how painful the situation was. ResultsMain results showed that greater interoceptive sensitivity enhanced the estimated degree of pain (cognitive empathy), as well as arousal and feelings of compassion (affective empathy), in response to painful pictures. ConclusionsThe accurate perception of bodily states and their representation shape both affective and cognitive empathy. This perception enables us to feel more compassion for another person and to evaluate the pain that they experience as being more intense.

Adenocarcinoma endometrial metastásico a un dedo

Cutaneous metastases may occur as the first manifestation of an unknown primary carcinoma. Their presentation is rare, they can debut as an infectious, painful picture and are of poor prognosis. The most frequent primary tumors that can compromise the skin are breast, lung, kidney and gastrointestinal tract. The next case is of a patient with metastasis of endometrial origin to the first finger of the right hand.

Acute Fetal Asphyxia After Gastric Rupture in a Pregnant Patient With a Gastric Band

We report a 37-year-old primigravida with a gastric band who developed the clinical picture of abdominal pain, vomiting and regurgitation coexistent with a cardiotocogram with severe variable decelerations with absent variability at 33 weeks' gestation. After partial improvement with gastric band enlargement, new aggravation of symptoms and recurrence of a pathological cardiotocogram led to an emergency cesarean section. Intraoperatively, hemoperitoneum from gastric rupture was verified and partial gastrectomy was performed. After bariatric surgery, pregnant women are at increased risk of gastrointestinal complications, which may need prompt and multidisciplinary diagnosis and management in order to avoid maternal-fetal morbidity and mortality.

Acute psychosocial stress and emotion regulation skills modulate empathic reactions to pain in others.

Psychosocial stress affects resources for adequate coping with environmental demands. A crucial question in this context is the extent to which acute psychosocial stressors impact empathy and emotion regulation. In the present study, 120 participants were randomly assigned to a control group vs. a group confronted with the Trier Social Stress Test (TSST), an established paradigm for the induction of acute psychosocial stress. Empathy for pain as a specific subgroup of empathy was assessed via pain intensity ratings during a pain-picture task. Self-reported emotion regulation skills were measured as predictors using an established questionnaire. Stressed individuals scored significantly lower on the appraisal of pain pictures. A regression model was chosen to find variables that further predict the pain ratings. These findings implicate that acute psychosocial stress might impair empathic processes to observed pain in another person and the ability to accept one's emotion additionally predicts the empathic reaction. Furthermore, the ability to tolerate negative emotions modulated the relation between stress and pain judgments, and thus influenced core cognitive-affective functions relevant for coping with environmental challenges. In conclusion, our study emphasizes the necessity of reducing negative emotions in terms of empathic distress when confronted with pain of another person under psychosocial stress, in order to be able to retain pro-social behavior.

Effects of ischemic compression of trigger points in painful episodes of patients with chronic shoulder pain. Systematic Review.

Introduction: Disorders of the shoulder are the major musculoskeletals morbidities, whose pathophysiological mechanisms of pain in the shoulder are poorly understood , myofascial trigger points are presented as alternative diagnosis of these disorders. Objective: To investigate the effectiveness of the release of trigger points on the pain symptoms in patients with chronic shoulder pain. Method: We conducted a descriptive study using a systematic literature review , in consultation with the databases PubMed , EMBASE , CINAHL , PEDro , SportDiscus , and LILACS . Two reviewers assessed the methodological quality of the selected studies , with the help of Quality Scale Jadad and PEDro scale. Results: The initial search resulted in 312 articles . After analyzing the titles and reading the abstracts , 70 studies that appeared repeatedly in more than one database and 214 who did not meet the predefined inclusion criteria , 28 texts were analyzed in their entirety were excluded , considering the inclusion and exclusion criteria defined only 2 articles were selected and subjected to analysis for methodological quality. Conclusion: The results demonstrate the importance of inspection and inactivation of myofascial trigger points in the muscles of the shoulder in patients with chronic pain , as they contribute to decreased overall picture of pain.

Polineuropatía motora subaguda secundaria a intoxicación por plomo

Las manifestaciones clínicas de la intoxicación por plomo son variadas e inespecíficas y continúan siendo un reto diagnóstico, en especial cuando son producto de presentaciones tan infrecuentes como las secundarias a fragmentos por proyectiles de arma de fuego intraarticulares. En suamplio espectro de manifestaciones se han descrito cambios que van desde el déficit de atenciónhasta estados más avanzados como las polineuropatías. El diagnóstico se basa principalmente enla medición del metal en distintos elementos del paciente y el tratamiento en medidas generales desoporte y terapia de quelación. Describimos el caso de un hombre con el antecedente de una herida por arma de fuego en caderaderecha, con un cuadro clínico progresivo de dolor abdominal, anemia acompañada de punteadobasófilo y manifestaciones neurológicas. Con un estudio por electromiografía que reporto unapolineuropatía axonal desmielinizante motora y sensitiva. Sus niveles séricos de plomo fueron 113µg/dL (Rango normal hasta 10 µg/dL) y después de un esquema de tratamiento con edetato calciodisódico (EDTA) más D penicilamina los síntomas neurológicos mejoraron asociado a un controlsérico de plomo de 49.1 µg/dL. Conclusión: la intoxicación por plomo es causa de polineuropatía motora subaguda especialmente en pacientes con exposición prolongada y niveles séricos altos de plomo

Acute fetal asphyxia after gastric rupture in a pregnant patient with a gastric band

We report a 37-year-old primigravida with a gastric band who developed the clinical picture of abdominal pain, vomiting and regurgitation coexistent with a cardiotocogram with severe variable decelerations with absent variability at 33 weeks' gestation. After partial improvement with gastric band enlargement, new aggravation of symptoms and recurrence of a pathological cardiotocogram led to an emergency cesarean section. Intraoperatively, hemoperitoneum from gastric rupture was verified and partial gastrectomy was performed. After bariatric surgery, pregnant women are at increased risk of gastrointestinal complications, which may need prompt and multidisciplinary diagnosis and management in order to avoid maternal-fetal morbidity and mortality.

Hemophagocytic Lymphohistiocytosis: Acute Liver Injury with A Unique Pathophysiology

Purpose: Hemophagocytic lymphohistiocytosis (HLH) is known within the realm of pediatrics as a lifethreatening condition that may be familial or associated with autoimmune disease, viral infections, or malignancies. However, its unique pathogenesis causes a misleading picture of abdominal pain, hepatosplenomegaly, elevated aminotransferases, and multiorgan failure. An 18-year-old female with no past medical history presented with one week of malaise, abdominal pain, and shortness of breath. She was febrile, in respiratory distress, and required vasopressors. Examination was notable for jaundice and bilateral upper quadrant abdominal tenderness. Labs were significant for pancytopenia, acute kidney injury, bilirubin of 34, ALT of 1279, AST of 1150, INR of 3.2, fibrinogen of 88, and ferritin of 1645. MRI of the abdomen revealed hepatosplenomegaly and hepatic edema. Extensive infectious work-up was negative, but the patient remained febrile, on vasopressors, and high-flow oxygen, despite receiving broad spectrum antibiotics. Bone marrow biopsy showed occasional erythrophagocytosis, not initially convincing for HLH. Thus, a trans-jugular liver biopsy was performed, which showed kupffer cell and histiocyte hypertrophy and erythrophagocytosis, confirming the diagnosis of HLH. The patient received dexamethasone and cyclosporine, and was weaned from vasopressors within two days. Her symptoms and labs improved quickly, and she was discharged home with close follow-up. HLH often presents as a non-specific constellation of acute liver injury, coagulopathy, and multi-organ system failure with the potential for rapid fatality. Its pathophysiology is related to decreased functional perforin levels and increased cytokines continually stimulating macrophage proliferation. This leads to a vague, yet severe, presentation, as seen in our patient. It is important to maintain a heightened awareness for HLH because of its reversibility with corticosteroids and cyclosporine, even at critical stages of illness.Figure: Liver biopsy showing portal inflammation with bile duct injury, pericholangitis, and kupffer cell and histiocyte hypertrophy with occasional erythrophagocytosis.

Developmental Data Supporting Simplification of Self-Report Pain Scales for Preschool-Age Children

Claims regarding the ability of preschool-age children to provide accurate self-reports using standard pain scales are not well supported by age-specific evidence. Responses of children younger than 5 years are often idiosyncratic and subject to biases. Simplifying the task of self-report of pain would make it more developmentally appropriate for 3- to 5-year-olds. A binary question is asked: “Does it hurt?” or an equivalent. If yes, a simplified scale is presented, comprising 3 categories representing low, medium, and high pain severity. Children aged 3 to 5 years (N = 184) were recruited from preschools and day care centers. Following parental consent and child assent, children were randomly assigned to use either the Faces Pain Scale–Revised or a 3-face scale preceded by a yes–no question to rate pain in 9 picture stories from the Charleston Pediatric Pain Pictures portraying no pain, moderate pain, and severe pain. The simplified pain rating task made no difference for 5-year-olds, whose mean scores were nearly identical using the 2 approaches. However, discrimination of the 3 levels of Charleston Pediatric Pain Pictures items was significantly better in 3- and 4-year-olds with the simplified task than with the Faces Pain Scale–Revised. Simplifying the task improved preschool-age children's ability to estimate pain intensity. PerspectiveStandard self-report pain scales with 6 faces are confusing for many 3- and 4-year-olds. In basic preparatory research for future development of a preschool self-report pain scale, we simplified the task. This simplification made no difference for 5-year-olds but improved the performance of 3- and 4-year-olds.

Early analgesic treatment regimens for patients with acute abdominal pain: a nationwide survey among general surgeons

Early pain relief in patients with acute nontraumatic abdominal pain in emergency departments has been discussed for years. Some randomized trials have addressed this issue but conclusive data are lacking. In this study, we assessed the current treatment practice in German hospitals in order to evaluate the necessity of a further clinical trial. An online survey containing 27 questions was sent to general and visceral surgeons at attending level using a mailing list provided by the Professional Board of German Surgeons (BDC) using a standard interview software. The questionnaire collected demographic data, current treatment policies about frequency of early analgesia, types of pain medication, and opinions about their use and effects. Four hundred ninety-five completed questionnaires were returned. Many surgeons were cautious about early analgesia in the emergency department. Forty-five percent of the surgeons would provide analgesia prior to diagnosis to the majority of patients. Within the departments, differing opinions existed regarding the analgesic treatment (41 %). Thirty-two percent of all the respondents knew about a false diagnosis after early analgesia. There was heterogeneity in the estimation of the impact of pain medication on masking of clinical symptoms. A randomized controlled trial would be supported by the majority of respondents. As influencing factors for withdrawing early analgesia, we found the examiner being over 40 years of age (p < 0.05), low experience with the clinical picture of acute abdominal pain (p < 0.05), high estimation of the masking of clinical findings (p < 0.001), and knowing about a false diagnosis after early analgesia (p < 0.001) to be significant. Discordance in the analgesic treatment regimens in patients with acute abdominal pain still exists in German hospitals. The topic remains subject of frequent discussions. More high quality data are needed before a clear guideline can be given for implementation in clinical routine management.

Efficacy of Physical Therapy in the Treatment of Gonarthrosis in Physically Burdened Working Men

Introduction:Gonarthrosis is most frequently defined as the change involving damage of the articular cartilage of the knee joint, emergence of abnormal knee tissue, reactive changes in synovial membrane, and pathological synovial fluid. The site of initial damage most often remains unknown. Goal of the researchThe goal:The goal of this research is to demonstrate the efficacy of individual physical therapy during the medical treatment for gonarthrosis in the working population engaged in physical labour, and to compare the state of pain and mobility before and after the treatment.Subjects and research methods:The research encompassed 30 subjects diagnosed with gonarthrosis, and it was conducted in the Institute of Occupational Health and Sports Medicine of the Zenica-Doboj Canton. On the basis of the applied physical treatments, we divided the subjects into control group and treatment group. All the subjects were treated during 21 days.Results and conclusions:In the largest number of subjects in both groups gonarthrosis occurred primarily as a consequence of knee joint trauma, and then because of weight and physical strain. Of the total number of subjects covered by this research, 9 subjects in control and 8 in treatment group had gonarthrosis of their right knee. 4 subjects in the control and 5 in the treatment group had gonarthrosis of the left knee, while 2 subjects from each group had gonarthrosis on both knees. By the analysis of clinical symptoms of gonarthrosis prior to the treatment, it was found that all the subjects from both groups had pain symptom, in 13 subjects from the control and 14 subjects from the treatment group limited range of motion was established, while 8 subjects from control and 9 subjects from treatment group had swelling in the joint area. The condition of the subjects prior to the treatment was analyzed by means of pain scale, and it was found that both groups experienced moderate level of pain before the treatment. After the 21st day of treatment, the pain intensity was again measured in the subjects that underwent combined physical and medication treatments. In the subjects from the control group that also underwent electrotherapy, the average pain scale value amounted to 2,33±1,34 after treatment, whereas in the subjects that underwent magnetotherapy and combined physical and medication treatments the pain scale amounted to 0,73±0,38. The ANOVA test showed that there is a statistically significant difference in the pain scale before and after the treatment, and also that the improvement in the clinical picture and reduction of pain occurred in both groups of subjects.

The effects of prior pain experience on neural correlates of empathy for pain: An fMRI study

Neuroimaging studies have revealed partially shared neural substrates for both the actual experience of pain and empathy elicited by the pain of others. We examined whether prior pain exposure increased neural activity in the anterior midcingulate cortex (aMCC) and bilateral anterior insula (AI) as a correlate of empathy for pain. Participants (N=64: 32 women, 32 men) viewed pictures displaying exposure to pressure pain (pain pictures) and pictures without any cue of pain (neutral pictures). Prior to the experiment, half of the participants were exposed to the same pain stimulus as the one seen in the pain pictures (pain exposure condition); the other half had no such experience (touch exposure condition). A balanced sex ratio was kept, to investigate possible sex differences. In the region-of-interest analyses, participants of the pain exposure condition showed decreased activity in the right AI and the aMCC relative to participants of the touch exposure condition. While in men, no differences were found in relation to their exposure condition, women with pain exposure showed decreased activity in the aMCC and additionally, in bilateral AI. Based on the entire sample, whole brain analyses revealed stronger activation in the retrosplenial cortex, dorsomedial prefrontal cortex, and medial prefrontal cortex in the pain exposure condition. In conclusion, prior pain exposure did not increase, but decreased activity in regions regularly associated with empathy for pain. However, pain experience increased activity in regions associated with memory retrieval, perspective taking, and top-down emotion regulation, which might facilitate empathizing with others.

Emotional primes modulate the responses to others’ pain: an ERP study

Previous event-related potential (ERP) and brain imaging studies have suggested observer responses to others' pain are modulated by various bottom-up and top-down factors, including emotional primes. However, the temporal dynamics underlying the impact of emotional primes on responses to others' pain remains poorly understood. In the present study, we explored effects of negative, neutral, and positive emotional priming stimuli on behavioral and cortical responses to visual depictions of others in pain. ERPs were recorded from 20 healthy adults, who were presented with painful and non-painful target pictures following observation of negative, neutral, and positive emotional priming pictures. ERP analyses revealed that relative to non-painful pictures, differential P3 amplitudes for painful pictures were larger followed by negative primes than either neutral or positive primes. There were no significant differential P3 amplitudes for painful pictures relative to non-painful pictures were found followed neutral and positive emotional primes. These results suggest that negative emotional primes strengthen observers' attention toward others' pain. These results support the threat value of pain hypothesis.

Klippel-Trenaunay syndrome: a rare cause of disabling pain after a femoral fracture

Klippel-Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, as well as bone and soft tissue hypertrophy of the extremity and venous malformations. We present the case of a 52-year-old man with a femoral fracture and a history of haemangiomas, limb bone hypertrophy and varicosity. The patient was finally diagnosed with KTS and treated in mini-invasive surgery by endomedullary fracture nailing in general anaesthesia. Clinical management was particularly demanding, not only because of the need to monitor the risk of haemorrhage and thrombosis but also because of the onset of a rare picture of neuropathic pain with hyperalgesia and allodynia, never previously reported in patients affected by KTS, that required the administration of major opioid drugs. According to our knowledge, this is the second case of KTS managed for femoral fracture. Unlike the previous report in literature, in this case a severe disabling neuropathic pain complicated the clinical management.

Increased Frontotemporal Activation During Pain Observation in Sexual Sadism

Sexual sadism is a psychiatric disorder in which sexual pleasure is derived from inflicting pain, suffering, or humiliation on others. While the psychological and forensic aspects of sexual sadism have been well characterized, little is known about the neurocognitive circuitry associated with the disorder. Sexual sadists show increased peripheral sexual arousal when observing other individuals in pain. The neural mechanisms underlying this unusual response are not well understood. We predicted that sadists relative to nonsadists would show increased responses in brain regions associated with sexual arousal (amygdala, hypothalamus, and ventral striatum) and affective pain processing (anterior cingulate and anterior insula) during pain observation. To study the neural correlates of pain observation in sadists and nonsadists. Case-control cross-sectional study. Sadists and nonsadists viewed 50 social scenes, 25 that depicted a person in pain (eg, one person stabbing another person's hand with scissors) and 25 thematically matched no-pain pictures (eg, one person stabbing a table with scissors, with another person's hand nearby). Pain severity ratings (range, 0 [none] to 4 [severe]) were acquired following each picture presentation. Sand Ridge Secure Treatment Center, Mauston, Wisconsin. Fifteen violent sexual offenders, including 8 sadists and 7 nonsadists (defined using the Severe Sexual Sadism Scale) who were matched for age, IQ, and education. Hemodynamic response revealed by functional magnetic resonance imaging and pain severity ratings. Sadists relative to nonsadists showed greater amygdala activation when viewing pain pictures. They also rated pain pictures higher on pain severity than nonsadists. Sadists but not nonsadists showed a positive correlation between pain severity ratings and activity in the anterior insula. These results provide neurobehavioral evidence of unusually heightened sensitivity to the pain of others in sadists.

Unstable Angina and Non–ST Elevation Myocardial Infarction

Non-ST elevation acute coronary syndromes are responsible for approximately 1 million admissions to U.S. hospitals and twice as many to European hospitals each year. Thus, they are among the most common serious illnesses in adults, and are associated with an in-hospital mortality of approximately 5%. The most common cause is rupture of an atherosclerotic coronary plaque, resulting in subtotal coronary occlusion. Diagnosis is based on the clinical picture of retrosternal chest pain, aided by electrocardiographic findings of ST segment deviations and biomarker abnormalities (elevation of troponin and natriuretic peptides) and cardiac imaging (myocardial scans showing perfusion defects). Treatment involves antiischemic agents (nitrates and β blockers), antiplatelet drugs (aspirin, P2Y(12), and glycoprotein IIb/IIIa receptor blockers), and anticoagulants (unfractionated and low-molecular-weight heparins). Patients should undergo risk stratification, and those with high-risk factors should undergo coronary arteriography promptly with the intent to carry out coronary revascularization. Those at low risk should continue to receive intensive antiischemic and antithrombotic therapy. At discharge, patients should receive intensive lipid-lowering therapy with high doses of a statin, as tolerated.

The multilevel organization of vicarious pain responses: Effects of pain cues and empathy traits on spinal nociception and acute pain

The shared-representation model of empathy suggests that vicarious pain processes rely partly on the activation of brain systems underlying self-pain in the observer. Here, we tested the hypothesis that self-pain may be facilitated by the vicarious priming of neural systems underlying pain perception. Pictures illustrating painful agents applied to the hand or the foot (sensory information), or painful facial expressions (emotional information) were shown to 43 participants to test the effects of vicarious pain on the nociceptive flexion reflex (NFR) of the lower limb and pain intensity and unpleasantness produced by transcutaneous electrical stimulation applied over the sural nerve. Results confirmed the expected priming effects of vicarious pain on spinal and perceptual processes. However, for comparable pain intensity and arousal evoked by the pain pictures, the facilitation of the NFR and the self-pain unpleasantness measurements was more robust in response to pictures depicting pain sensory compared to emotional information. Furthermore, the facilitation of the NFR by pain pictures was positively correlated with the empathy trait of the observer. In contrast, the change in perceived shock-pain intensity was negatively correlated with empathic traits. This dissociation implies that low-level vicarious priming processes underlying pain facilitation may be downregulated at higher pain-processing stages in individuals reporting higher levels of empathy. We speculate that this process contributes to reducing self–other assimilation and is necessary to adopt higher-order empathic responses and altruistic behaviors.A priming effect of vicarious pain and individuals’ empathic traits on self-pain processing at different levels of the neuraxis is revealed.