Shared and distinct functional networks for empathy and pain processing: a systematic review and meta-analysis of fMRI studies

Fallon, Nicholas; Roberts, Carl A.; Stančák, Andrej

doi:10.1093/scan/nsaa090

Cited by 93 publications

(60 citation statements)

References 80 publications

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“…Notably, the anterior insula cortex plays a complex role in processes directly or indirectly related to the acute and chronic pain experience, including pain empathy (Fallon et al, 2020; Xu et al, 2020b; Zhou et al, 2020), interoception and salience processing (Yao et al, 2018; Li et al, 2018) as well as emotional experience (Gogolla, 2017).…”

Section: Discussionmentioning

confidence: 99%

Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain – convergent evidence from neuroimaging meta-analysis

Ferraro

Klugah‐Brown

Tench

et al. 2021

Preprint

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Neurobiological pain models propose that the transition from acute to chronic pain is accompanied by neuropathological adaptations that mediate progressive pain processing dysfunctions. In contrast, meta-analytic studies on neurofunctional dysregulations in chronic pain have not revealed convergent evidence for robust alterations during experimental pain induction. Against this background, the present neuroimaging meta-analysis combined three different meta-analytic approaches with stringent study selection criteria for case-control functional magnetic resonance imaging experiments during acute pain processing with a focus on chronic pain disorders (i.e., fibromyalgia, irritable bowel syndrome, chronic low back pain, neuropathic pain; n = 295 patients, n = 211 controls; 86 foci). Across the meta-analytic approaches, convergent neurofunctional dysregulations in chronic pain patients were observed in the left anterior insula cortex, with study characteristics indicating generalized pain processing abnormalities. Seed-based resting-state functional connectivity based on a large publicly available dataset combined with a meta-analytic task-based approach identified the anterior insular region as a key node of an extended bilateral insula-fronto-cingular network, resembling the salience network. Moreover, the meta-analytic decoding showed that this region presents a high probability to be specifically activated during pain-related processes. Together, the present findings indicate that dysregulated left anterior insular activity represents a robust neurofunctional maladaptation and potential treatment target in chronic pain disorders.

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Section: Discussionmentioning

confidence: 99%

Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain – convergent evidence from neuroimaging meta-analysis

Ferraro

Klugah‐Brown

Tench

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Converging evidence from functional neuroimaging and lesion studies indicate that the temporoparietal junction (TPJ), which is situated at the posterior superior temporal sulcus (pSTS), and medial prefrontal cortex (mPFC) are essential for detecting and representing mental states of others, and play an important role in cognitive empathy and moral cognition ( Decety and Lamm, 2007 , Gallagher and Frith, 2003 , Lamm et al, 2007 , Moll et al, 2007 , Saxe et al, 2004 , Silani et al, 2013 , Yoder and Decety, 2014a ). In healthy participants, viewing others in pain reliably elicits response in dorsal anterior cingulate (dACC) and anterior insula (aINS; Decety et al, 2013a , Fallon et al, 2020 , Lamm et al, 2011 ), core nodes of the salience network which integrate multiple stimuli to coordinate cortical and subcortical resources to respond to motivationally relevant stimuli ( Decety, 2011 , Harsay et al, 2012 , Shackman et al, 2011 , Yoder and Decety, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Neural responses to morally laden interactions in female inmates with psychopathy

Yoder

Harenski

Kiehl

et al. 2021

NeuroImage: Clinical

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“…Studies have shown that when observing others in pain, brain regions involved in the processing of self‐directed pain were also activated, but this mainly included parts of the affective‐motivational component of pain processing, such as the anterior mid‐cingulate cortex (aMCC) and the anterior insula (AI) (Botvinick et al., 2005; Lamm et al., 2011; Singer et al., 2004). Recent meta‐analytic research has revealed additional activations shared by empathy for pain and self‐direct pain in the inferior frontal gyrus and supramarginal gyri (Fallon et al., 2020). Besides, another meta‐analysis research demonstrated that the core neural empathy network (aMCC and AI) was activated when observing others in painful states as well as in nonpain negative affective states (Timmers et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Pharmacological fMRI provides evidence for opioidergic modulation of discrimination of facial pain expressions

et al. 2020

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The endogenous opioid system is strongly involved in the modulation of pain. However, the potential role of this system in perceiving painful facial expressions from others has not been sufficiently explored as of yet. To elucidate the contribution of the opioid system to the perception of painful facial expressions, we conducted a double‐blind, within‐subjects pharmacological functional magnetic resonance imaging (fMRI) study, in which 42 participants engaged in an emotion discrimination task (pain vs. disgust expressions) in two experimental sessions, receiving either the opioid receptor antagonist naltrexone or an inert substance (placebo). On the behavioral level, participants less frequently judged an expression as pain under naltrexone as compared to placebo. On the neural level, parametric modulation of activation in the (putative) right fusiform face area (FFA), which was correlated with increased pain intensity, was higher under naltrexone than placebo. Regression analyses revealed that brain activity in the right FFA significantly predicted behavioral performance in disambiguating pain from disgust, both under naltrexone and placebo. These findings suggest that reducing opioid system activity decreased participants' sensitivity for facial expressions of pain, and that this was linked to possibly compensatory engagement of processes related to visual perception, rather than to higher level affective processes, and pain regulation.

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Shared and distinct functional networks for empathy and pain processing: a systematic review and meta-analysis of fMRI studies

Cited by 93 publications

References 80 publications

Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain – convergent evidence from neuroimaging meta-analysis

Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain – convergent evidence from neuroimaging meta-analysis

Neural responses to morally laden interactions in female inmates with psychopathy

Pharmacological fMRI provides evidence for opioidergic modulation of discrimination of facial pain expressions

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