Anterior insular cortex is necessary for empathetic pain perception
Open accessAbstract
Empathy refers to the ability to perceive and share another person's affective state. Much neuroimaging evidence suggests that observing others' suffering and pain elicits activations of the anterior insular and the anterior cingulate cortices associated with subjective empathetic responses in the observer. However, these observations do not provide causal evidence for the respective roles of anterior insular and anterior cingulate cortices in empathetic pain. Therefore, whether these regions are 'necessary' for empathetic pain remains unknown. Herein, we examined the perception of others' pain in patients with anterior insular cortex or anterior cingulate cortex lesions whose locations matched with the anterior insular cortex or anterior cingulate cortex clusters identified by a meta-analysis on neuroimaging studies of empathetic pain perception. Patients with focal anterior insular cortex lesions displayed decreased discrimination accuracy and prolonged reaction time when processing others' pain explicitly and lacked a typical interference effect of empathetic pain on the performance of a pain-irrelevant task. In contrast, these deficits were not observed in patients with anterior cingulate cortex lesions. These findings reveal that only discrete anterior insular cortex lesions, but not anterior cingulate cortex lesions, result in deficits in explicit and implicit pain perception, supporting a critical role of anterior insular cortex in empathetic pain processing. Our findings have implications for a wide range of neuropsychiatric illnesses characterized by prominent deficits in higher-level social functioning.
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Emotion recognition and empathic deficits occur after insular cortex lesions.
“emotion recognition and empathic deficits occur after insular cortex lesions3–5”
From Insular cortex mediates approach and avoidance responses to social affective stimuli (2018) · cites this paper as [3]
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- Authors
- Gu, X., Gao, Z., Wang, X., Liu, X., Knight, R. T., Hof, P. R., & Fan, J.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Capital Medical University (CN)
- Chinese Academy of Sciences (CN)
- University of California, Berkeley (US)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-08-29
- Volume
- 135
- Issue
- 9
- Pages
- 2726-2735
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC3437027
- OpenAlex
- W2150382179
- Cited by
- 223
- References
- 16
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 21 · 2023: 10 · 2022: 18 · 2021: 13 · 2020: 14 · 2019: 22 · 2018: 20 · 2017: 13 · 2016: 19 · 2015: 21 · 2014: 17 · 2013: 9
- FWCI
- 22.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Brain (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion)
- Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion, cc-by-nc-sa)
- Funders
- James S. McDonnell Foundation
- National Institutes of Health (2r01ns021135-33, NS21135)
- National Institute of Mental Health (R21MH083164)
- National Institute of Neurological Disorders and Stroke (NS-21135, R01 NS-021135)
- Topics
- Social Sciences › Psychology › Social Psychology › Action Observation and Synchronization
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- anterior insula, anterior cingulate cortex, pain perception, lesion studies, interference effects, social cognition
- MeSH terms
- Adult, Brain Injuries, Brain Mapping, Cerebral Cortex, Empathy, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Pain, Photic Stimulation, Pain Perception
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