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Is there a core neural network in empathy? An fMRI based quantitative meta-analysis
Abstract
Whilst recent neuroimaging studies have identified a series of different brain regions as being involved in empathy, it remains unclear concerning the activation consistence of these brain regions and their specific functional roles. Using MKDA, a whole-brain based quantitative meta-analysis of recent fMRI studies of empathy was performed. This analysis identified the dACC-aMCC-SMA and bilateral anterior insula as being consistently activated in empathy. Hypothesizing that what are here termed affective-perceptual and cognitive-evaluative forms of empathy might be characterized by different activity patterns, the neural activations in these forms of empathy were compared. The dorsal aMCC was demonstrated to be recruited more frequently in the cognitive-evaluative form of empathy, whilst the right anterior insula was found to be involved in the affective-perceptual form of empathy only. The left anterior insula was active in both forms of empathy. It was concluded that the dACC-aMCC-SMA and bilateral insula can be considered as forming a core network in empathy, and that cognitive-evaluative and affective-perceptual empathy can be distinguished at the level of regional activation.
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“the literature currently lacks a specific meta-analytic investigation and comprehensive systematic review on the relationship between empathy and the MNS.”
From Is the Putative Mirror Neuron System Associated with Empathy? A Systematic Review and Meta-Analysis (2021) · cites this paper as Fan, Duncan, de Greck, & Northoff, 2011
In the citing paper
“Similar to previous findings (Fan et al., 2011; Lamm et al., 2011; Shamay-Tsoory, 2011), whole-brain analyses of the contrast of painful vs. neutral expressions revealed activations in both the empathy network, including the anterior cingulate and bilateral AI/inferior frontal gyrus (IFG), and the theory-of-mind network, including the mPFC, left TPJ, and right temporal pole (TP) (all activations”
From A neurobiological association of revenge propensity during intergroup conflict (2020) · cites this paper as Fan et al., 2011
In the citing paper
“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).”
From Parsing the neural correlates of moral cognition: ALE meta-analysis on morality, theory of mind, and empathy (2012) · cites this paper as Fan et al. 2011
In the citing paper
“Two recent cross-sectional meta-analyses suggest that empathy for pain crucially involves anterior insula (AI) and anterior midcingulate cortex (aMCC) (Fan et al., 2011;Lamm et al., 2011).”
From Differential pattern of functional brain plasticity after compassion and empathy training (2014) · cites this paper as Fan et al., 2011
In the citing paper
“These results align with and extend previous crosssectional meta-analytic findings on a crucial role of insula and aMCC in empathy for pain (Fan et al., 2011;Lamm et al., 2011)”
From Differential pattern of functional brain plasticity after compassion and empathy training (2014) · cites this paper as Fan et al., 2011
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“, 2007), the insular cortex (Fan et al., 2011; Lamm et al., 2011) and other components of the so-called pain matrix (Peyron et al.”
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“Subcortical areas (i.e., midbrain areas), develop in association with these other areas (Fan et al., 2011) emphasising the possibility of automatic and unconscious functioning (Giannopulu and Watanabe, 2015, 2018; Giannopulu et al., 2016, 2018; Giannopulu, 2018).”
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“One important aspect of prosocial behavior is empathy, the ability to perceive and understand the emotions or situations of others. fMRI studies have shown that the insula is consistently activated during empathy-related information processing (Fan et al., 2011).”
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“Empathy has also been an area of interest in neuroscience, particularly focusing on empathy for pain (e.g., Xu et al., 2009; Fan et al., 2011; Contreras-Huerta et al., 2013; Cao et al., 2015).”
BackgroundEEG and fMRI evidence for autobiographical memory reactivation in empathy
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“It enables one to perceive and understand the feelings and experiences of those around us, comprehending that information cognitively, and then allowing for appropriate responding, which forms the basis for much of our society [20].”
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“The left insula is associated with empathy in affective perceptual and cognitive assessment forms (44).”
BackgroundIntracranial EEG signals disentangle multi-areal neural dynamics of vicarious pain perception
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“…studies have documented the important role of the amygdala in empathic responses 28 – 30 , the fMRI evidence for the involvement of the amygdala in human empathy has been inconsistent 9,54,55 , leaving whether the amygdala is crucial for the processing of human empathy for pain an open question.”
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“Whilst the LDLPFC has been implicated in empathic processing, evidence from functional neuroimaging studies suggests a greater role for subcortical structures like the ACC (Fan et al., 2011).”
BackgroundInfluentialFavre, P., Kanske, P., Engen, H. G., & Singer, T. (2021) · NeuroImage · doi:10.1016/j.neuroimage.2021.118132 · Cited by 25
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The influence of role awareness, empathy induction and trait empathy on dictator game giving
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“Activation of aMCC was also robust during empathy for pain (Lamm et al., 2011) and for the other’s negative emotion such as disgust (Prehn-Kristensen et al., 2009). dlPFC was supposed to take part in emotion regulation processes (Fan et al., 2011; Etkin et al., 2015).”
BackgroundNeglectful maternal caregiving involves altered brain volume in empathy-related areas
López, M. J. R., León, I., García‐Pentón, L., Hernandez-Cabrera, J. A., & Quiñones, I. (2019) · Development and Psychopathology · doi:10.1017/s0954579419001469 · Cited by 17
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“…remain: increased posterior but decreased anterior insula activation may reflect heightened interoceptive but decreased affective processing ( Kirk et al., 2011), and rightward lateralization suggests a shift toward perceptual rather than cognitive empathy ( Fan et al., 2011; Lutz et al., 2008a).”
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“…in the insular cortex (also responsible for the social cognition that generates empathy) of subjects during compassion exercises (Desbordes et al., 2012), and changes in grey matter concentration in brain regions recruited in empathy and perspective-taking (Fan et al., 2011; Hölzel et al., 2011).”
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“Furthermore, there is evidence that the anterior insula has a strong connection with the amygdala [17,18] and is enrolled in emotional processing and empathy [19].”
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“…supplementary motor area (dACC-aMCC-SMA), the bilateral anterior insular cortex and adjacent inferior frontal gyrus, the bilateral dorsal medial thalamus, medial orbital frontal cortex, and midbrain (Fan et al., 2010), are predicted to be recruited during the learning process of mate copying.”
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“Because of the existence of a perception-action cortical (Stephens, Silbert, & Hasson, 2010) and sub-cortical (Fan, Duncan, de Greck, & Northoff, 2011) neural coupling, neurotypically developing children are able to consider verbal and nonverbal communication of their partners.”
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“, 2011), specifically when empathizing with others that are suffering pain, fear, happiness, discomfort, and anxiety (Fan et al., 2011).”
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“…amygdala and striatum are key components of the parental caregiving brain network (24,25), and FC between the amygdala, striatum, and para-limbic and cortical brain regions implicated in empathy and emotion regulation (26,27) subserve parents ’ ability to adaptively respond to their children (28).”
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“It has been shown that the activation of IFG, anterior cingulate cortex, and SMA is generally associated with affective empathy (Fan et al., 2011).”
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“Meta-analytic evidence supported that empathy tasks could activate the ACC ( − 2, 24, 38), the anterior insula (left: − 44, 18, 0; right: 40, 24, − 4)) [14] and the TPJ (left anterior: − 53, − 30, 10; right anterior: 47, − 35, 12; left posterior: − 53, − 59, 20; right posterior: 56, − 56,18) [17].”
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“…occipital fasciculus L 20 −35 −21 −4 .023* Right anterior insula A Inferior fronto- occipital fasciculus R Inferior longitudinal fasciculus R 74 247 −54 19 .023* B Inferior fronto- occipital fasciculus R 13 25 −48 22 .025* *p < .001; and cognitive– evaluative forms of empathy (Fan et al., 2011).”
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“In schizophrenia, some authors have described neurofunctional and structural alterations in certain brain regions recruited in empathy tasks, such as the TPJ (Benedetti et al., 2009), the amygdala and other frontotemporoparietal regions involved in empathy processing (SMA/aMCC) (Derntl et al., 2012; Smith et al., 2015…”
BackgroundInfluentialEmotional, especially negative microblogs are more popular on the web: evidence from an fMRI study
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“In terms of brain activity associated with negative microblogs, insula is the key node that has been implicated in emotional empathy, especially to the negative experience occurring to the other or feeling of other ’ s pain (meta analyses from Fan et al. 2011; Lamm et al. 2011).”
BackgroundPain Management - Practices, Novel Therapies and Bioactives
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“3 Though we refer to this large cluster as dACC throughout based on the location of peak voxels, this cluster is large across stimulus domains and, similar to meta-analytic descriptions of empathy-related brain response (Fan et al., 2011), extends to include the anterior MCC and SMA.”
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“Secondly, there are two types of empathy for pain: physiological and social (Fan et al., 2010).”
BackgroundMenks, W. M., Fehlbaum, L. V., Borbás, R., Sterzer, P., Stadler, C., & Raschle, N. M. (2020) · NeuroImage Clinical · doi:10.1016/j.nicl.2020.102519 · Cited by 14
“The observed reduction in insula activity during emotional face processing in individuals with CD might therefore be linked to a weaker salience detection and insensitivity to affective stimuli, especially considering the insula’s role in affective empathy (Fan et al., 2011).”
Vicarious praise and pain: parental neural responses to social feedback about their adolescent child
van Houtum, L. A. E. M., Wever, M. C. M., Janssen, L. H. C., van Schie, C. C., Will, G., Tollenaar, M. S., & Elzinga, B. M. (2021) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsab004 · Cited by 13
“These findings are also in line with prior studies showing that parents engage ACC and AI not only when experiencing negative affect themselves but also when empathizing with their child’s experiences of negative emotions or pain (Fan et al., 2011; Feldman, 2015; Abraham et al., 2018).”
ResultProblem gambling during Covid-19
Frisone, F., Alibrandi, A., & Settineri, S. (2020) · Mediterranean Journal of Clinical Psychology · doi:10.6092/2282-1619/mjcp-2457 · Cited by 30
Báez, S., Fittipaldi, S., de la Fuente, L. A., Carballo, M., Ferrando, R., Cordero, I. R. G., Campo, C. G., García, A. M., Sedeño, L., & Ibáñez, A. M. (2021) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2021.110328 · Cited by 16
Picerni, E., Laricchiuta, D., Piras, F., Vecchio, D., Petrosini, L., Cutuli, D., & Spalletta, G. (2021) · Scientific Reports · doi:10.1038/s41598-021-87861-0 · Cited by 15
“Humans and records are entangled”: empathic engagement and emotional response in archivists
Regehr, C., Duff, W. M., Aton, H., & Sato, C. (2022) · Archival Science · doi:10.1007/s10502-022-09392-5 · Cited by 14
Pain Empathy and Its Association with the Clinical Pain in Knee Osteoarthritis Patients
Zhao, R., Ji, Y., Li, J., Li, X., Wu, T., Wu, H., & Liu, C. (2022) · Journal of Pain Research · doi:10.2147/jpr.s379305 · Cited by 15
“Explicitly assessing others’ pain intensity via perspective-taking reflects an individual’s cognitive empathy in responding to painful stimuli.(11,12) Notably, previous research regarding the affective”
BackgroundPhysiological and health-related correlates of the narcissistic personality
Konrath, S., & Bonadonna, J. P. (2014) · IUScholarWorks (Indiana University) · Cited by 14
Integrative neurocognitive mechanism of empathy and counter-empathy
Fu, D., Qi, Y., Wu, H., & Liu, X. (2017) · Chinese Science Bulletin (Chinese Version) · doi:10.1360/n972016-01108 · Cited by 14
The Neural Correlates of Impaired Self-Monitoring Among Individuals With Neurodegenerative Dementias
Parthimos, T. P., Karavasilis, E., Rankin, K. P., Seimenis, I., Leftherioti, K., Papanicolaou, A. C., Miller, B. L., Papageorgiou, S. G., & Papatriantafyllou, J. D. (2019) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.17120349 · Cited by 15
Rodríguez-Gómez, P., Martín‐Loeches, M., Colmenares, F., Ferreiro, M. V. R., & Moreno, E. M. (2020) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-020-00773-w · Cited by 14
Social preferences correlate with cortical thickness of the orbito-frontal cortex
Fariña, A., Rojek-Giffin, M., Gross, J., & Dreu, C. K. W. D. (2021) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsab074 · Cited by 14
Is Empathy Associated with Gambling and Its Addiction? A Scoping Review of Empirical Studies
Wu, A. M. S., Zhou, H., Dang, L., & Chen, J. H. (2022) · Journal of Gambling Studies · doi:10.1007/s10899-022-10130-w · Cited by 15
“, 2014a), which is a key brain region for empathy (Fan et al., 2011).”
BackgroundThe association between ballroom dance training and empathic concern: Behavioral and brain evidence
Wu, X. X., Lu, X., Zhang, H., Wang, X., Kong, Y., & Hu, L. (2022) · Human Brain Mapping · doi:10.1002/hbm.26042 · Cited by 13
“According to a well-recognized meta-analysis on empathy network (Fan et al., 2011), a series of empathy-related regions of interest (ROIs) in the AAL3 atlas (Rolls et al., 2020) were defined in this study.”
BackgroundMethodConnected in Bad Times and in Good Times: Empathy Induces Stable Social Closeness
Saulin, A., Ting, C.-C., Engelmann, J. B., & Hein, G. (2024) · Journal of Neuroscience · doi:10.1523/jneurosci.1108-23.2024 · Cited by 16
Almeida, R., Prata, C., Pereira, M. R., Barbosa, F., & Ferreira‐Santos, F. (2024) · Brain Sciences · doi:10.3390/brainsci14050504 · Cited by 13
The striatal matrix compartment is expanded in autism spectrum disorder
Waugh, J. L., Hassan, A. O. A., Funk, A. T., & Maldjian, J. A. (2025) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-025-09596-7 · Cited by 13
Anders, S., Verrel, J., Haynes, J., & Ethofer, T. (2020) · Cortex · doi:10.1016/j.cortex.2020.06.015 · Cited by 13
The neural correlates of paternal consoling behavior and frustration in response to infant crying
Rilling, J. K., Richey, L., Andari, E., & Hamann, S. B. (2021) · Developmental Psychobiology · doi:10.1002/dev.22092 · Cited by 11
Winters, D. E., & Hyde, L. W. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.08.103 · Cited by 12
Lower affective empathy in oral contraceptive users: a cross-sectional fMRI study
Kimmig, A.-C. S., Wildgruber, D., Gärtner, A., Drotleff, B., Krylova, M., Lämmerhofer, M., Poromaa, I. S., & Derntl, B. (2022) · Cerebral Cortex · doi:10.1093/cercor/bhac345 · Cited by 14
Healthcare experience affects pain‐specific responses to others' suffering in the anterior insula
Corradi‐Dell’Acqua, C., Hofstetter, C., Sharvit, G., Hügli, O., & Vuilleumier, P. O. (2023) · Human Brain Mapping · doi:10.1002/hbm.26468 · Cited by 13
“…and dorsal-anterior cingulate cortex (dACC), in the processing and empathizing with other people's pain (as conveyed by faces, pictures, text, etc.) (Ding et al., 2019; Y. Fan et al., 2011; Jauniaux et al., 2019; Kogler et al., 2020; Lamm et al., 2011; Schurz et al., 2021; Timmers et al., 2018).”
BackgroundYin, L., He, Y., Dong, X., & Lu, Z. (2013) · Journal of Computers · doi:10.4304/jcp.8.6.1449-1455 · Cited by 13
“The neural network [3-6]. not only has the selfadaptive, parallelism and fault tolerance characteristics, but also has the ability to approximate any nonlinear function.”
BackgroundBDNF Val66Met Polymorphism Is Associated with Self-Reported Empathy
Taschereau‐Dumouchel, V., Hétu, S., Bagramyan, A., Labrecque, A., Racine, M., Chagnon, Y. C., & Jackson, P. L. (2016) · PLoS ONE · doi:10.1371/journal.pone.0149911 · Cited by 14
Dong, D., Ming, Q., Wang, X., Yu, W., Jiang, Y., Wu, Q., Gao, Y., & Yao, S. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.02085 · Cited by 13
“Conclusions: Adolescents with CD exhibited dampened hemodynamic responses during pain-related empathy processing in the bilateral TPJ, a region associated with cognitive empathy.”
The impact of individuation on the bases of human empathic responding
Kiat, J. E., & Cheadle, J. E. (2017) · NeuroImage · doi:10.1016/j.neuroimage.2017.05.006 · Cited by 13
“…engaged, developmental (Decety, 2010), behavioral (Harari et al., 2010; Mazza et al., 2014), neuroimaging (Banissy et al., 2012; Cox et al., 2012; Eres et al., 2015; Fan et al., 2011), and anatomical (Shamay-Tsoory et al., 2009) evidence suggest that they rely on distinct, dissociable systems.”
Neural correlates of moral goodness and moral beauty judgments
Cheng, Q., Cui, X., Lin, J., Weng, X., & Mo, L. (2019) · Brain Research · doi:10.1016/j.brainres.2019.146534 · Cited by 14
Schmidt, A., Davies, C., Paloyelis, Y., Meyer, N., Micheli, A. D., Ramella‐Cravaro, V., Provenzani, U., Aoki, Y. Y., Rutigliano, G., Cappucciati, M., et al. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-00885-4 · Cited by 14
Neuroanatomical Correlates of Social Intelligence Measured by the Guilford Test
Myznikov, A., Zheltyakova, M., Korotkov, A. D., Kireev, M. V., Masharipov, R. S., Jagmurov, O. D., Habel, U., & Votinov, M. (2021) · Brain Topography · doi:10.1007/s10548-021-00837-1 · Cited by 16
“For example, the anterior insular cortex is known to be the core element of empathy, which is closely related to affective TOM (Fan et al., 2011).”
BackgroundTaubner, S., Hauschild, S., Wisniewski, D., Wolter, S., Roth, G., & Fehr, T. (2021) · Brain and Behavior · doi:10.1002/brb3.2400 · Cited by 13
“Additionally, both groups showed insula and postcentral gyrus involvement, which have previously been associatedwithmental states of aversion and pain expectancy (Decety, 2010; Fan et al., 2011; Gu et al., 2010).”
BackgroundMatiz, A., Crescentini, C., Bergamasco, M., Budai, R., & Fabbro, F. (2021) · Consciousness and Cognition · doi:10.1016/j.concog.2021.103210 · Cited by 14
Plank, I. S., Attar, C. H., Kunas, S. L., Dziobek, I., & Bermpohl, F. (2021) · Scientific Reports · doi:10.1038/s41598-021-02162-w · Cited by 15
Lan, C., Chen, Y., Zhang, Y., Kou, J., Huang, L., Xu, T., Yang, X., Xu, D., Yang, W., Kendrick, K. M., et al. (2023) · Neuroendocrinology · doi:10.1159/000531064 · Cited by 12
Swain, J. E., & Ho, S.-H. S. (2023) · Journal of Neuroendocrinology · doi:10.1111/jne.13316 · Cited by 11
Genzer, S., Adiva, Y. B., & Perry, A. (2023) · Cambridge University Press eBooks · doi:10.1017/9781009281072 · Cited by 20
The vocal side of empathy: neural correlates of pain perception in spoken complaints
Mauchand, M., Armony, J. L., & Pell, M. D. (2023) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsad075 · Cited by 12
“Whereas the ToM network is often associated with cognitive empathy, salience network activity may reflect a more affective component of the phenomenon, driven by a vicarious experience of other’s suffering (Fan et al. , 2011).”
Background
Metadata
- Authors
- Fan, Y., Duncan, N. W., de Greck, M., & Northoff, G.
- Affiliations
- University of Ottawa (CA)
- Corresponding author
- Northoff, Georg
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 35
- Issue
- 3
- Pages
- 903-911
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W2088335634
- Semantic Scholar
- a0ef877b20f7510e11539ab069df023ea45c7501
- Cited by
- 902
- References
- 89
- Citations by year
- 2026: 41 · 2025: 44 · 2024: 49 · 2023: 56 · 2022: 82 · 2021: 90 · 2020: 77 · 2019: 65 · 2018: 55 · 2017: 67 · 2016: 57 · 2015: 75 · 2014: 58 · 2013: 47 · 2012: 28
- FWCI
- 3.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Salus Foundation
- German Research Foundation
- SFB/DFG
- Hope of Depression Research Foundation (HDRF)
- Topics
- Social Sciences › Psychology › Social Psychology › Action Observation and Synchronization
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- empathy, dorsal anterior cingulate cortex, supplementary motor area, anterior insula
- MeSH terms
- Brain, Brain Mapping, Cognition, Empathy, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Neural Pathways, Neuropsychological Tests, Oxygen, Meta-Analysis as Topic
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