Anterior insular cortex is necessary for empathetic pain perception
Anterior insular cortex is necessary for empathetic pain perception
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DOI：
10.1093/brain/aws199
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发表时间：
2012-09-01
期刊：
影响因子：
14.5
通讯作者：
Fan, Jin
中科院分区：
文献类型：
--
作者：
Gu, Xiaosi;Gao, Zhixian;Fan, Jin
移情是指感知和分享他人情感状态的能力。许多神经影像学证据表明，观察他人的痛苦和疼痛会激发前岛叶和前扣带皮层的激活，这与观察者的主观移情反应有关。然而，这些观察并没有提供因果关系的证据，前岛叶和前扣带皮层在共情痛各自的作用。因此，这些区域是否是共情疼痛所必需的仍然是未知的。在此，我们研究了前岛叶皮层或前扣带皮层病变患者对他人疼痛的感知，这些病变的位置与前岛叶皮层或前扣带皮层簇相匹配，这些簇是通过对移情疼痛感知的神经影像学研究进行荟萃分析确定的。局灶性前岛叶皮层损伤的患者在明确处理他人疼痛时表现出辨别准确性降低和反应时间延长，并且缺乏典型的移情疼痛对疼痛无关任务的干扰作用。相比之下，在前扣带皮层病变患者中未观察到这些缺陷。这些研究结果表明，只有离散的前岛叶皮层病变，而不是前扣带皮层病变，导致赤字的显式和隐式的疼痛感知，支持的关键作用，前岛叶皮层在移情疼痛处理。我们的研究结果对广泛的神经精神疾病具有重要意义，这些疾病的特征是高级社会功能的显著缺陷。
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.