Search

Medical students and professional healthcare providers often underestimate patients' pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self-pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other's pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self-pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others' suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain that is shared with that of first-hand nociception, and related more to AI than to other pain-responsive regions. Taken together, our study suggests a decreased propensity to appraise others' suffering as one's own, associated with a reduced recruitment of pain-specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings., (© 2023 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)

Background: Embodied models of social cognition argue that others' affective states are processed by re-enacting a sensory-specific representation of the same state in the observer. However, neuroimaging studies suggest that a reliable part of the representation shared between self and others is supramodal and relates to dimensions such as Unpleasantness or arousal, common to qualitatively different experiences. Here we investigated whether representations of first-hand pain and disgust influenced the subsequent evaluation of facial expressions in Modality-specific fashion, or in terms of Unpleasantness or arousal., Methods: Thirty volunteers were subjected to thermal painful and olfactory disgusting events, and subsequently were asked to classify computer-generated faces expressing pain (characterized by high Unpleasantness and arousal), disgust (high Unpleasantness and low arousal), surprise (low Unpleasantness and high arousal) and hybrid combinations thereof., Results: Thermal and olfactory events were associated with comparable Unpleasantness ratings and heart rate (but stronger galvanic response was found for painful temperatures). Furthermore, we found that the appraisal of facial expressions was biased by the prior stimulus, with more frequent pain classifications following thermal stimuli, and more frequent disgust classifications following olfactory stimuli. Critically, this modulation was cross-modal in nature, as each first-hand stimulation influenced in comparable fashion facial traits diagnostic of both pain and disgust, without instead generalizing to features of surprise., Conclusion: Overall, these data support the presence of shared coding between one's aversive experiences and the appraisal of others' facial responses, which is best describable as supramodal representation of the Unpleasantness of the experience., Significance: These results extend previous findings about common representational coding between the experience of first-hand and others' pain. In particular, they highlight that reliable part of the information shared is supramodal in nature and relates to a broad dimension of Unpleasantness common also to painless aversive states such as disgust., (© 2019 European Pain Federation - EFIC®.)

People's sensitivity to first-hand pain is affected by their ongoing emotions, with positive states (joy, amusement) exerting analgesic-like effects, and negative states (sadness, fear) often enhancing the subjective experience. It is however less clear how empathetic responses to others' pain are affected by one's own emotional state. Following embodied accounts that posit a shared representational code between self and others' states, it is plausible that pain empathy might be influenced by emotions in the same way as first-hand pain. Alternatively, other theories in psychology suggest that social resources (including empathetic reactions) might be enhanced by positive states, but inhibited by negative states, as only in the former case, one's mindset is sufficiently broad to take into consideration others' needs. To disambiguate between these opposing predictions, we conducted two experiments in which volunteers observed positive, neutral, or negative video clips, and subsequently either received painful thermal stimuli on their own body (first-hand pain), or observed images of wounded hands (others' pain). We measured subjective pain ratings as well as physiological responses and brain activity using fMRI. We found that, contrary to the case of first-hand pain, others' pain produced weaker galvanic responses and lower neural activity in anterior insula and middle cingulate cortex following negative (relative to neutral and positive) videos. Such inhibition was partially counteracted by personal empathy traits, as individuals with higher scores retained greater sensitivity to others' pain after negative emotion induction, in both behavioral and neural responses in medial prefrontal cortex. Furthermore, multivoxel pattern analysis confirmed similar neural representation for first-hand and others' pain in anterior insula, with representation similarity increasing the more the video preceding the observation of others' suffering was positive. These findings speak against the idea that emotion induction affects first-hand and others' pain in an isomorphic way, but rather supports the idea that contrary to negative emotions, positive emotions favors a broader access to social resources., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The superior temporal sulcus (STS) is a major component of the human face perception network, implicated in processing dynamic changeable aspects of faces. However, it remains unknown whether STS holds functionally segregated subdivisions for different categories of facial movements. We used high-resolution functional magnetic resonance imaging (fMRI) at 7T in 16 volunteers to compare STS activation with faces displaying angry or happy expressions, eye-gaze shifts and lip-speech movements. Combining univariate and multivariate analyses, we show a systematic topological organization within STS, with gaze-related activity predominating in the most posterior and superior sector, speech-related activity in the anterior sector and emotional expressions represented in the intermediate middle STS. Right STS appeared to hold a finer functional segregation between all four types of facial movements, and best discriminative abilities within the face-selective posterior STS (pSTS). Conversely, left STS showed greater overlap between conditions, with a lack of distinction between mouth movements associated to speech or happy expression and better discriminative abilities (for gaze and speech vs emotion conditions) outside pSTS. Differential sensitivity to upper (eye) or lower (mouth) facial features may contribute to, but does not appear to fully account for, these response patterns., (© The Author (2017). Published by Oxford University Press.)

The anterior insula (AI) and mid-anterior cingulate cortex (mACC) have repeatedly been implicated in first-hand and vicarious experiences of pain, disgust and unfairness. However, it is debated whether these regions process different aversive events through a common modality-independent code, reflecting the shared unpleasantness of the experiences or through independent modality-specific representations. Using functional magnetic resonance imaging, we subjected 19 participants (and 19 confederates) to equally unpleasant painful and disgusting stimulations, as well as unfair monetary treatments. Multivoxel pattern analysis identified modality-independent activation maps in the left AI and mACC, pointing to common coding of affective unpleasantness, but also response patterns specific for the events' sensory properties and the person to whom it was addressed, particularly in the right AI. Our results provide evidence of both functional specialization and integration within AI and mACC, and support a comprehensive role of this network in processing aversive experiences for self and others.

Pain sensitivity increases when a noxious stimulus is preceded by cues predicting higher intensity. However, it is unclear whether the modulation of nociception by expectancy is sensory-specific ("modality based") or reflects the aversive-affective consequence of the upcoming event ("unpleasantness"), potentially common with other negative events. Here we compared expectancy effects for pain and disgust by using different, but equally unpleasant, nociceptive (thermal) and olfactory stimulations. Indeed both pain and disgust are aversive, associated with threat to the organism, and processed in partly overlapping brain networks. Participants saw cues predicting the unpleasantness (high/low) and the modality (pain/disgust) of upcoming thermal or olfactory stimulations, and rated the associated unpleasantness after stimuli delivery. Results showed that identical thermal stimuli were perceived as more unpleasant when preceded by cues threatening about high (as opposed to low) pain. A similar expectancy effect was found for olfactory disgust. Critically, cross-modal expectancy effects were observed on inconsistent trials when thermal stimuli were preceded by high-disgust cues or olfactory stimuli preceded by high-pain cues. However, these effects were stronger in consistent than inconsistent conditions. Taken together, our results suggest that expectation of an unpleasant event elicits representations of both its modality-specific properties and its aversive consequences.

Understanding emotions in others engages specific brain regions in temporal and medial prefrontal cortices. These activations are often attributed to more general cognitive 'mentalizing' functions, associated with theory of mind and also necessary to represent people's non-emotional mental states, such as beliefs or intentions. Here, we directly investigated whether understanding emotional feelings recruit similar or specific brain systems, relative to other non-emotional mental states. We used functional magnetic resonance imaging with multivoxel pattern analysis in 46 volunteers to compare activation patterns in theory-of-mind tasks for emotions, relative to beliefs or somatic states accompanied with pain. We found a striking dissociation between the temporoparietal cortex, that exhibited a remarkable voxel-by-voxel pattern overlap between emotions and beliefs (but not pain), and the dorsomedial prefrontal cortex, that exhibited distinct (and yet nearby) patterns of activity during the judgment of beliefs and emotions in others. Pain judgment was instead associated with activity in the supramarginal gyrus, middle cingulate cortex and middle insular cortex. Our data reveal for the first time a functional dissociation within brain networks sub-serving theory of mind for different mental contents, with a common recruitment for cognitive and affective states in temporal regions, and distinct recruitment in prefrontal areas., (© The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.)

Rejections of unfair offers in the ultimatum game (UG) are commonly assumed to reflect negative emotional arousal mediated by the anterior insula and medial prefrontal cortex. We aimed to disentangle those neural mechanisms associated with direct personal involvement ('I have been treated unfairly') from those associated with fairness considerations, such as the wish to discourage unfair behavior or social norm violations ('this person has been treated unfairly'). For this purpose, we used fMRI and asked participants to play the UG as responders either for themselves (myself) or on behalf of another person (third party). Unfair offers were equally often rejected in both conditions. Neuroimaging data revealed a dissociation between the medial prefrontal cortex, specifically associated with rejections in the myself condition, thus confirming its role in self-related emotional responses, and the left anterior insula, associated with rejections in both myself and third-party conditions, suggesting a role in promoting fair behavior also toward third parties. Our data extend the current understanding of the neural substrate of social decision making, by disentangling the structures sensitive to direct emotional involvement of the self from those implicated in pure fairness considerations.

The discovery of regions in the human brain (e.g., insula and cingulate cortex) that activate both under direct exposure to pain and when perceiving pain in others has been interpreted as a neural signature of empathy. However, this overlap raises the question of whether it may reflect a unique distributed population of bimodal neurons or, alternatively, the activity of intermingled but independent populations. We used fMRI on 28 female volunteers and used multivariate pattern analysis techniques to probe for more fine-grain spatial representations of seen and felt pain. Using a whole-brain approach, we found that only in the anterior insula (bilaterally) the distribution of cortical activity evoked by seeing another person's hand in pain was spatially similar to that of pain felt on one's own hand. Subsequent region of interest analyses also implicated the middle insula (right hemisphere) and the middle cingulate cortex. Furthermore, for the anterior insula, the spatial distribution of activity associated with one's pain also replicates that of the perception of negative but painless stimuli. Our data show how the neural representations of aversive events affecting oneself are also recruited when the same events affect others, and provide the stronger evidence thus far of a unique distributed cortical ensemble coding for aversive events regardless of the subject who is affected.

The "irrational" rejections of unfair offers by people playing the Ultimatum Game (UG), a widely used laboratory model of economical decision-making, have traditionally been associated with negative emotions, such as frustration, elicited by unfairness (Sanfey, Rilling, Aronson, Nystrom, & Cohen, 2003; van't Wout, Kahn, Sanfey, & Aleman, 2006). We recorded skin conductance responses as a measure of emotional activation while participants performed a modified version of the UG, in which they were asked to play both for themselves and on behalf of a third-party. Our findings show that even unfair offers are rejected when participants' payoff is not affected (third-party condition); however, they show an increase in the emotional activation specifically when they are rejecting offers directed towards themselves (myself condition). These results suggest that theories emphasizing negative emotions as the critical factor of "irrational" rejections (Pillutla & Murninghan, 1996) should be re-discussed. Psychological mechanisms other than emotions might be better candidates for explaining this behaviour.

Extensive neuroimaging literature suggests that understanding others' thoughts and emotions engages a wide network encompassing parietal, temporal and medial frontal brain areas. However, the causal role played by these regions in social inferential abilities is still unclear. Moreover very little is known about theory of mind deficits in brain tumours and whether potential anatomical substrates are comparable to those identified in functional MRI literature. This study evaluated the performance of 105 tumour patients, before and immediately after brain surgery, on a cartoon-based non-verbal task evaluating cognitive (intention attribution) and affective (emotion attribution) theory of mind, as well as a non-social control condition (causal inference). Across multiple analyses, we found converging evidence of a double dissociation between patients with right superior parietal damage, selectively impaired in intention attribution, and those with right anteromedial temporal lesion, exhibiting deficits only in emotion attribution. Instead, patients with damage to the frontal cortex were impaired in all kinds of inferential processes, including those from the non-social control conditions. Overall, our data provide novel reliable causal evidence of segregation between different aspects of the theory of mind network from both the cognitive and also the anatomical point of view. [ABSTRACT FROM AUTHOR]

Expectations modulate the subjective experience of pain by increasing sensitivity to nociceptive inputs, an effect mediated by brain regions such as the insula. However, it is still unknown whether the neural structures underlying pain expectancy hold sensory-specific information or, alternatively, code for modality-independent features (eg, unpleasantness), potentially common with other negative experiences. We used functional magnetic resonance imaging to investigate neural activity underlying the expectation of different, but comparably unpleasant, pain and disgust. We presented participants with visual cues predicting either a painful heat or disgusting odor, and assessed how they affected the subsequent subjective experience of stimuli from the same (within-modality) or opposite (cross-modal) modality. We found a reliable influence of expectancy on the subjective experience of stimuli whose modality matched that of the previous cue. At the brain level, this effect was mediated by the intermediate dysgranular section of the insula, whereas it was suppressed by more anterior agranular portions of the same region. Instead, no expectancy modulation was observed when the modality of the cue differed from that of the subsequent stimulus. Our data suggest that the insular cortex encodes prospective aversive events in terms of their modality-specific features, and whether they match with subsequent stimulations. [ABSTRACT FROM AUTHOR]

The authors discuss role of emotion in determining social behavior. They state that a research on the topic conducted by Swiss National Center of Competence in Research, and mention use of laboratory-controlled settings or real-life situations in the research. They note significance of human-environment interaction and highlights individual social behavior.

Seminal theories posit that social and physical suffering underlie partly-common representational code. It is unclear, however, if this shared information reflects a modality-specific component of pain, or alternatively a supramodal code for properties common to many aversive experiences (unpleasantness, salience, etc.). To address this issue, we engaged participants in a gaming experience in which they were excluded or included by virtual players. After each game session, participants were subjected to comparably-unpleasant painful or disgusting stimuli. Subjective reports and cardiac responses revealed a reduced sensitivity to pain following exclusion relative to inclusion, an effect which was more pronounced in those participants who declared to feel more affected by the gaming manipulation. Such modulation was not observed for disgust. These findings indicate that the relationship between social and physical suffering does not generalize to disgust, thus suggesting a shared representational code at the level of modality-specific components of pain. [ABSTRACT FROM AUTHOR]