Inability to empathize: brain lesions that disrupt sharing and understanding another’s emotions.
Open accessAbstract
Emotional empathy--the ability to recognize, share in, and make inferences about another person's emotional state--is critical for all social interactions. The neural mechanisms underlying emotional empathy have been widely studied with functional imaging of healthy participants. However, functional imaging studies reveal correlations between areas of activation and performance of a task, so that they can only reveal areas engaged in a task, rather than areas of the brain that are critical for the task. Lesion studies complement functional imaging, to identify areas necessary for a task. Impairments in emotional empathy have been mostly studied in neurological diseases with fairly diffuse injury, such as traumatic brain injury, autism and dementia. The classic 'focal lesion' is stroke. There have been scattered studies of patients with impaired empathy after stroke and other focal injury, but these studies have included small numbers of patients. This review will bring together data from these studies, to complement evidence from functional imaging. Here I review how focal lesions affect emotional empathy. I will show how lesion studies contribute to the understanding of the cognitive and neural mechanisms underlying emotional empathy, and how they contribute to the management of patients with impaired emotional empathy.
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Cognitive empathy (CE) is a prerequisite for emotional empathy (EE).
“integrative approaches propose that the experience of empathy evolves as a dynamic interplay between them requiring an explicit representation of the specific affective state of the other person, thereby making CE a prerequisite for EE (Decety and Jackson, 2004; Hillis, 2014).”
From Oxytocin Enhancement of Emotional Empathy: Generalization Across Cultures and Effects on Amygdala Activity (2018) · cites this paper as Hillis, 2014
For direct and indirect emotional empathy measures, only trials with correct cognitive empathy recognition were analyzed.
“Based on previous conceptualizations of empathy, proposing that CE is a prerequisite for EE (Decety and Jackson, 2004; Hillis, 2014), for EED and EEI measures only trials for which subjects successfully recognized the emotions displayed by the protagonist were analyzed [for a similar approach see Luo et al. (2015a)].”
From Oxytocin Enhancement of Emotional Empathy: Generalization Across Cultures and Effects on Amygdala Activity (2018) · cites this paper as Hillis, 2014
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Social Psychology and Noninvasive Electrical Stimulation: A Promising Marriage
Boggio, P. S., Rêgo, G. G., Marques, L. M., & Costa, T. L. (2016) · European Psychologist · doi:10.1027/1016-9040/a000247 · Cited by 13 · see citing works
Early environmental influences on the orbito-frontal cortex function and its effects on behavior
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Amygdala network reorganization mediates the theory of mind performances in multiple sclerosis
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Impaired Empathy Versus General Hypoemotionality in Frontotemporal Dementia
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- Authors
- Hillis, A. E.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Hillis, Argye E.
- ORCID
- Hillis, Argye E.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-11-30
- Volume
- 137
- Issue
- 4
- Pages
- 981-997
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC3959550
- OpenAlex
- W2148900213
- Cited by
- 158
- References
- 108
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 8 · 2022: 23 · 2021: 17 · 2020: 5 · 2019: 20 · 2018: 21 · 2017: 11 · 2016: 10 · 2015: 17 · 2014: 7
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Brain (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R01 NS47691, R01NS047691)
- Topics
- Social Sciences › Psychology › Social Psychology › Action Observation and Synchronization
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Keywords
- affective empathy, brain lesions, stroke, focal brain injury, social cognition, emotional understanding, neural mechanisms of empathy
- MeSH terms
- Brain, Empathy, Humans, Stroke
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