Is there a core neural network in empathy? An fMRI based quantitative meta-analysis

“Specifically, studies of adults have revealed enhancements in functional activity of a social-cognitive network supporting facets of mentalizing and empathy (Singer and Lamm, 2009; de Greck et al., 2012; Fan et al., 2011).”

“Compared with recent coordinate-based meta-analysis (Caspers et al., 2010; Fan et al., 2011; Kim, 2011; Sabatinelli et al., 2011), the present study selected the coordinates within different clusters from the total self condition randomly to make four subgroups, and got similar results.”

“…in vicarious responses in the domain of disgust, pleasant or unpleasant tastes, physical and emotional pain, and other social emotions such as embarrassment or admiration (for recent meta-analyses, see Fan et al. 2011, Kurth et al. 2010, Lamm et al. 2011; for anatomical orientation, see Figure 1a).”

“Interoception-related meta-representation of emotion has thus been suggested to underlie the concomitant involvement of the aMCC/SMA and AI/IFG in neuroimaging studies on empathy as reflecting affective sharing (Singer and Lamm 2009; Fan et al. 2011).”

“In keeping with previous findings on the neural substrates of empathy, we expected that empathy for HE videos would be accompanied by activations in the AI and the aMCC, which are the core regions of the empathy for pain network (Fan et al. 2011; Lamm et al. 2011).”

“…instructed versus uninstructed tasks.16 Note that several other (and partially related) categorizations have been discussed elsewhere but go beyond the scope of our exemplary illustration (see, e.g., Fan et al., 2011; Mar, 2011; Molenberghs et al., 2016; Timmers et al., 2018; Van Overwalle, 2009).”

“While the amygdala is usually not considered part of the core brain network for empathy (Fan et al., 2011; Shamay-Tsoory, 2011), several neuroimaging studies of empathy and compassion have implicated the amygdala.”

“…neural correlates of face perception (Haxby et al., 2002) and empathy (Carr et al., 2003; Decety et al., 2016; Decety and Lamm, 2007; Decety, 2011; Fan et al., 2011; Mutschler et al., 2013; Singer and Lamm, 2009; Shamay-Tsoory et al., 2009; Shamay-Tsoory, 2011), others have described the…”

“2002], empathy [Fan et al., 2011], drug craving [Naqvi”

“Meta-analyses show that the anterior insula (AI) and middle anterior cingulate cortex (mACC) are core regions underlying empathic responding when witnessing others' suffering and when suffering oneself (Fan et al., 2011; Lamm et al., 2011).”

“…et al. 2010), and numerous other processes—and this variety is recapitulated in an equally broad range of meta-analyses that also report anterior insula activation, such as studies of empathy (Fan et al. 2011), subsequent memory (Kim 2011), and working memory (Owen et al. 2005), among others.”

“1B, Table 1], supporting the well-documented evidence that these regions engage when observing another in pain (Singer et al., 2004; Gu et al., 2010; Fan et al., 2011) as well as during physical pain (Eisenberger and Lieberman, 2004; Atlas et al.”

“…(Carr et al., 2003; Zaki et al., 2009; Decety, 2010; Fan et al., 2011) often due to a lack of agreement regarding the terminology and cognitive constructs employed [e.g. empathy for pain (Decety, 2010), Theory of Mind (ToM) (Saxe, 2006), automatic vs controlled empathy (Fan et al., 2011)].”

“At first glance, meta-analyses appear to confirm the view that dACC and AI support core aspects of empathy for the emotions of others (Fan et al., 2011; Lamm et al., 2011).”

“…others’ suffering has been suggested to involve the anterior insula (AI) and mid cingulate cortex (mCC) (Singer and Lamm, 2009; Kurth et al., 2010; Fan et al., 2011), whereas perspective taking recruits the temporoparietal junction (TPJ), posterior superior temporal sulcus (pSTS), temporal…”

“…(e.g., Wittmann, van Wassenhove, Craig, & Paulus, 2010), music appreciation (e.g., Blood & Zatorre, 2001), emotional experience (e.g., Zaki, Davis, & Ochsner, 2012), and social cognition (e.g., Y. Fan et al., 2011; Lamm & Singer, 2010; Singer, Critchley, & Preuschoff, 2009; Wicker et al., 2003).”

“More specifically, we expected reduced functioning of the anterior insular cortex, which has been proven a key mediator of the otheroriented sharing of the emotions (Fan et al., 2011; Lamm et al., 2011; Singer et al., 2009).”

“This is in line with the findings on the neural correlates of empathy showing a common network for personal feeling and seeing emotions in others (for a recent meta-analysis, see Fan et al. [2011]).”

“faces, images of others in pain or crying sounds (Fan et al., 2011), has highlighted the functional importance of medial PFC, precuneus/poste-”

“It is worth noting that, the cingulate cortex is believed to be mostly related with the motivational and volitional aspects of pain processing, such as preparation and regulation of associated motor and autonomic responses (Craig, 2002; Critchley, 2005; Fan et al., 2011; Medford et al., 2010; Vogt et al., 2003).”

“For socio-affective processing, studies have consistently identified a network, including limbic/paralimbic cortical areas, such as the anterior insula (AI) and anterior cingulate cortex (ACC) for empathy (8, 9, 20, 21), together with lateral areas involved in emotion regulation, such as the dorsolateral prefrontal co…”

“In a nutshell, the MKDA is a ‘random effects’ approach (Fan et al., 2011; Kober & Wager, 2010; Wager et al., 2009), given that: a) it nests peak activation coordinates within contrasts, and contrasts within studies; b) it models the variability across peaks within a contrast, rather than just…”

“This finding has since been confirmed by numerous subsequent studies, as documented by image-based and coordinate-based meta-analyses which have quantitatively integrated and summarized the available data (Fan et al., 2011; Lamm et al., 2011).”

“, 2007), one's own emotional responses and empathy for others' emotional states (e.g., ACC and insula, Singer et al., 2004; Jackson et al., 2005; Saarela et al., 2007; Gu and Han, 2007; Han et al., 2009; Gu et al., 2010; Fan et al., 2011; Lamm et al., 2011).”

“At the same time, the anterior cingulate region and its connections remain strongly implicated in emotional processes (Dalgleish, 2004; Etkin et al., 2011, 2015; Fan et al., 2011).”

“…dorsal anterior cingulate cortex (dACC) and anterior insular (aINS) cortices when both experiencing pain and observing pain in others ( Corradi-Dell’Acqua et al., 2011 ; 2016 ; Fan et al., 2011 ; Jackson et al., 2005 ; 2006a ; Lamm et al., 2007 ; 2011 ; Ogino et al., 2007 ; Singer et al., 2004 ).”

“For example, we did not find the aMCC or the aIns to be central to empathic care or distress, in distinction from prior work (CorradiDell’Acqua et al., 2016; Fan et al., 2011; Klimecki et al., 2014; Lamm et al., 2011; Singer and Klimecki, 2014).”

“Examples include pain to self and another [8,9], monetary and social reward [10,11], and one’s own or another’s action goals [12,13].”

“A regions of interest (ROI) approach was used based on coordinates provided by a recent meta-analysis (Fan et al., 2011; Table 1) which showed that the insula was most often associated with affective empathy (left insula; x = -42, y = 18, z = 0 and right insula; x = 38, y = 24, z = -2) and the…”

“We also show a negative association between callous traits and responses in AI and ACC, regions related to unpleasant emotions generated in response to others’ pain [7, 8].”

“Consistent fMRI evidence has demonstrated increased neural responses to the physical pain of others in the anterior cingulate cortex (ACC), supplementary motor area (SMA), anterior insula (AI), second somatosensory cortex (SII), inferior parietal cortex, and amygdala [24,25].”

“, empathy) and pain in social neuroscience (Lamm and Singer 2010; Fan et al. 2011; Bzdok et al. 2012b), and is today understood as an integrating link between large-scale brain systems (Kurth et al.”

“the attunement of the therapeutic relationship turns so profound and intense to become embodied simulation [160], also through mirror neurons [161], therapist and patient can start to share not only the distress but also the ability to limit it.”

“This oxytocininduced heightened insula reactivity in women may underlie an affective empathic reaction (Fan et al., 2011) during these social situations and may be a female- or paradigm-specific neural finding; oxytocin administration in men did not affect empathy-related insula activity while…”

“Such representation includes its associated autonomic and somatic responses, neurally associated with the activation of the anterior insula and dorsal anterior cingulate cortex [122, 123], which provides support to the concept of a mirroring, sensorimotor, and nature of empathy [124].”

“…connected to the yellow cluster, have been conceptualized as a salience network (Seeley et al. 2007; Menon and Uddin 2010), potentially involved in interoceptive awareness (Critchley 2004), pain detection (Vogt 2005; Lamm et al. 2011), and empathy (Fan et al. 2011; Bzdok, Schilbach, et al. 2012).”

“A previous meta-analysis revealed that while both types of paradigms elicit left AI, perceptual/affective empathy paradigms tend to elicit more right AI/IFG activation, while cognitive/evaluative paradigms tend to elicit more MCC activation (Fan et al., 2011).”

“These areas have been associated with social reward (Krach et al. 2010), emotional empathy (AbuAkel & Shamay-Tsoory 2011; Fan et al. 2012), cognitive empathy (CE) and theory of mind (ToM; Gallagher & Frith 2003; Blair 2005; Vollm et al. 2006; Fan et al. 2012).”

“and tasks (Fan et al. 2011), which found a division of labor in the anterior insula based on laterality, with the left insula implicated in both affective–perceptual and cognitive–evaluative forms of empathy.”

“, in “cognitive empathy” that adopts a wider focus on context and reflects through the perspective of the other (Fan et al., 2011).”

“, [13,27,47]), a draft of the neuroanatomical structure for the above computational model is”

“Finally, more focused meta-analysis of responses to others' emotional states suggests that tasks involving passive viewing (dubbed “affective-perceptual empathy”) activate the bilateral insula, whereas tasks involving assessments of others' emotional states (cognitive empathy) activate the mid-cingulate cortex.(52) Wi…”

“Interestingly, the results of this meta-analysis are in line with another meta-analysis performed by Fan et al. (2011) focusing on empathy studies conducted with fMRI in general not just restricted to pain.”

“Previous meta-analyses of empathic processing (Fan et al., 2011; Lamm et al., 2011; Timmers et al., 2018; Jauniaux et al., 2019) were also screened for additional articles although this did not lead to the inclusion of any further studies.”

“In addition to previous meta-analyses (Fan et al., 2011; Timmers et al., 2018) we investigated the evaluative component of empathy in more detail.”

“These reliable activations in the dACC and AI have led some researchers to conclude that these regions are part of a core network in empathy (Fan et al., 2011).”

“Shamay-Tsoory et al. (2009) summarized the differences between these two separate systems (see Table 2) Fana et al. (2011) reported some differences in the recruited brain regions when subjects were unaware of being tested for empathy (which they called affective-perceptual), than when they were…”

“Although empathy has historically been defined in many ways (Batson, 2009), recent social neuroscience research has made considerable progress in identifying key brain-based subcomponents of empathy (Fan et al., 2011) and understanding how empathy is impacted in various forms of psychopathology (Decety and Moriguchi,…”

“…empathy for pain activates brain areas overlapping with those that are activated during the first-hand experience of pain (Lamm et al., 2011, for meta-analysis), and this finding also extends to affective experiences other than pain (Fan et al., 2011, for meta-analysis; see also Lamm et al., 2015).”

“For instance, Fan et al. (2011) conducted a meta-analysis across 40 studies and reported that the left anterior insula was consistently activated during both affective and cognitive empathy tasks.”

“These are consistent with the previous neuroimaging findings that suggest that the insula is engaged in an affective–perceptual form of empathy when participants observe others in pain and are unaware of the goal of the experiments (Fan et al., 2011).”

“Our study found one significant difference from the prior (Gu Han, 2007b) study of pain words: the cingulate cortex did not ignificantly distinguish between painful and non-painful events n Gu and Han (2007b), but did in the current results.”

“…suggesting that the anterior cingulate cortex represents a core brain region for emotional empathy in general and pain empathy in particular (Fan et al., 2011; Jauniaux et al., 2019; Timmers et al., 2018), we found overlapping deactivations in the rostral and ventral anterior cingulate…”

“Recent meta-analyses highlight the primary roles of anterior insula and adjacent frontooperculum (AI/FO; extending into inferior frontal gyrus [IFG]) and ACC (particularly dorsal and middle regions [dACC/aMCC]).(40,41) AI supports interoceptive awareness,(42) uncertainty monitoring,(1) and salienceprocessing,(43) whil…”

“The right temporoparietal junction (TPJ) and left SMA are, respectively, associated with mental state inference (Cheon et al., 2011; Sheng et al., 2014) and motor motivation (Fan et al., 2011) during empathy.”