Hearing other's pain is associated with sensitivity to physical pain: An ERP study

Autistic and Non-autistic Children's Pain Perception is Modulated by Their First-Hand Pain Sensitivity and Theory of Mind

The current study examined whether autistic children's perception of others' pain could be modulated by their first-hand pain sensitivity and theory of mind (ToM). We measured the first-hand pain sensitivity, the rating of others' pain intensity, and the performance in the ToM tasks in 43 5- to 8-year-old autistic and 30 neurotypical children. Our results revealed hyposensitivity to first-hand pain, underestimation of others' pain intensity, as well as difficulties in the False Belief subtasks of ToM in autistic children. Furthermore, we detected an interaction between children's first-hand pain sensitivity and ToM in predicting their perception of others' pain. To be specific, for autistic and NT children with normal or hyper-sensitivity to first-hand pain, better performance on ToM predicted higher ratings for others' pain intensity; while for autistic and NT children with hyposensitivity to first-hand pain, ToM did not predict ratings for others' pain intensity. Our study contributes to the understanding of pain perception in young children and provides implications for clinical practices to improve social understanding in autistic children.

Vocal Emotion Recognition in Autism: Behavioral Performance and Event-Related Potential (ERP) Response

Autistic youth display difficulties in emotion recognition, yet little research has examined behavioral and neural indices of vocal emotion recognition (VER). The current study examines behavioral and event-related potential (N100, P200, Late Positive Potential [LPP]) indices of VER in autistic and non-autistic youth. Participants (N = 164) completed an emotion recognition task, the Diagnostic Analyses of Nonverbal Accuracy (DANVA-2) which included VER, during EEG recording. The LPP amplitude was larger in response to high intensity VER, and social cognition predicted VER errors. Verbal IQ, not autism, was related to VER errors. An interaction between VER intensity and social communication impairments revealed these impairments were related to larger LPP amplitudes during low intensity VER. Taken together, differences in VER may be due to higher order cognitive processes, not basic, early perception (N100, P200), and verbal cognitive abilities may underlie behavioral, yet occlude neural, differences in VER processing.

The Empathy for Pain Stimuli System (EPSS): Development and preliminary validation

We present the Empathy for Pain Stimuli System (EPSS): a large-scale database of stimuli for studying people's empathy for pain. The EPSS comprises five sub-databases. First, the Empathy for Limb Pain Picture Database (EPSS-Limb) provides 68 painful and 68 non-painful limb pictures, exhibiting people's limbs in painful and non-painful situations, respectively. Second, the Empathy for Face Pain Picture Database (EPSS-Face) provides 80 painful and 80 non-painful pictures of people's faces being penetrated by a syringe or touched by a Q-tip. Third, the Empathy for Voice Pain Database (EPSS-Voice) provides 30 painful and 30 non-painful voices exhibiting either short vocal cries of pain or neutral interjections. Fourth, the Empathy for Action Pain Video Database (EPSS-Action_Video) provides 239 painful and 239 non-painful videos of whole-body actions. Finally, the Empathy for Action Pain Picture Database (EPSS-Action_Picture) provides 239 painful and 239 non-painful pictures of whole-body actions. To validate the stimuli in the EPSS, participants evaluated the stimuli using four different scales, rating pain intensity, affective valence, arousal, and dominance. The EPSS is available to download for free at https://osf.io/muyah/?view_only=33ecf6c574cc4e2bbbaee775b299c6c1 .

The effect of top-down attention on empathy fatigue

Prolonged exposure to others' suffering can lead to empathy fatigue, especially when individuals struggle to effectively regulate their empathic capacity. Shifting active attention away from emotional components toward cognitive components of others' suffering is an effective strategy for mitigating empathy fatigue. This research investigated how top-down attentional manipulation modulates empathy fatigue in both auditory (Study 1) and visual (Study 2) modalities. Participants completed two tasks in both studies: (i) the attention to cognitive empathy task (A-C task) and (ii) the attention to emotional empathy task (A-E task). Each task included three blocks (Time Block 1, Time Block 2, and Time Block 3) designed to induce empathy fatigue. Study 1 revealed that the A-C task reduced empathy fatigue and N1 amplitudes than the A-E task in Time Block 3, indicating that attention to cognitive empathy might decrease auditory empathy fatigue. Study 2 indicates that the A-C task caused a longer N2 latency than the A-E task, signifying a decelerated emotional empathic response when attention was on cognitive empathy in the visual modality. Overall, prioritizing cognitive empathy seems to conserve mental resources and reduce empathy fatigue. This research documented the relationship between top-down attention and empathy fatigue and the possible neural mechanism.

The alterations in event-related potential responses to pain empathy in breast cancer survivors treated with chemotherapy

Background

Previous findings indicated that breast cancer patients often have dysfunction in empathy and other cognitive functions during or after chemotherapy. However, the manifestations and possible neuro-electrophysiological mechanisms of pain empathy impairment in breast cancer patients after chemotherapy were still unknown.

Objective

The current study aimed to investigate the potential correlations between pain empathy impairment and event-related potentials (ERP) in breast cancer patients undergoing chemotherapy.

Methods

Twenty-two breast cancer patients were evaluated on a neuropsychological test and pain empathy paradigm before and after chemotherapy, containing the Chinese version of the Interpersonal Reactivity Index (IRI-C), while recording ERP data.

Results

The empathic concern scores were lower and personal distress scores were higher on IRI-C task compared with those before chemotherapy (t = 3.039, p < 0.01; t = −2.324, p < 0.05, respectively). Meanwhile, the accuracy rates were lower than those before chemotherapy for both pain and laterality tasks on the pain empathy paradigm (F = 5.099, P = 0.035). However, the response time was no significant differences before and after chemotherapy (F = 0.543, P = 0.469). Further, the amplitude of the N1 component was significantly increased (F = 38.091, P < 0.001), and the amplitude of the P2 component was significantly decreased (F = 15.046, P = 0.001) in the subsequent ERP study. A linear mixed effect model was used to analyze the correlation, the average amplitude of N1 and P2 were positively correlated with the accuracy rates in laterality tasks (r = 1.765, r = 1.125, respectively, P < 0.05).

Conclusion

The results indicated that pain empathy impairment was performed in chemotherapeutic breast cancer patients, which was possibly correlated to the changes of N1 and P2 components in ERP. These findings provide neuro-electrophysiological information about chemo-brain in breast cancer patients.

Ongoing first-hand pain facilitates somatosensory resonance but inhibits affective sharing in empathy for pain

Alterations of empathy for others' pain among patients with chronic pain remained inconsistent. Here, applying a capsaicin-based ongoing pain model on healthy participants, this study investigated how ongoing first-hand pain influences empathic reactions to vicarious pain stimuli. Healthy participants were randomly treated with topical capsaicin cream (capsaicin group) or hand cream (control group) on the left forearm. Video clips showing limbs in painful and non-painful situations were used to induce empathic responses. The capsaicin group showed greater empathic neural responses in the right primary somatosensory cortex (S1) than the control group but smaller responses in the left anterior insula (AI) accompanied with smaller empathic pain-intensity ratings. Notably, the intensity of ongoing pain negatively correlated with empathy-related neural responses in the left AI. Inter-subject phase synchronization analysis was used to assess stimulus-dependent dynamic functional connectivity within or between brain regions engaged in pain empathy. The capsaicin group showed greater empathy-related neural synchronization within S1 and between S1 and AI, but less synchronization within AI and between AI and MCC. Behaviorally, the differential inter-subject pain-intensity rating alignment between painful and non-painful videos was more positive for the capsaicin group than for the control group, and this effect was partially mediated by the inter-subject neural synchronization between S1 and AI. These results suggest that ongoing first-hand pain facilitates neural activation and synchronization within brain regions associated with empathy-related somatosensory resonance at the cost of inhibiting activation and synchronization within brain regions engaged in empathy-related affective sharing.

Hyper-Sensitivity to Pitch and Poorer Prosody Processing in Adults With Autism: An ERP Study

Individuals with autism typically experience a range of symptoms, including abnormal sensory sensitivities. However, there are conflicting reports on the sensory profiles that characterize the sensory experience in autism that often depend on the type of stimulus. Here, we examine early auditory processing to simple changes in pitch and later auditory processing of more complex emotional utterances. We measured electroencephalography in 24 adults with autism and 28 controls. First, tones (1046.5Hz/C6, 1108.7Hz/C#6, or 1244.5Hz/D#6) were repeated three times or nine times before the pitch changed. Second, utterances of delight or frustration were repeated three or six times before the emotion changed. In response to the simple pitched tones, the autism group exhibited larger mismatch negativity (MMN) after nine standards compared to controls and produced greater trial-to-trial variability (TTV). In response to the prosodic utterances, the autism group showed smaller P3 responses when delight changed to frustration compared to controls. There was no significant correlation between ERPs to pitch and ERPs to prosody. Together, this suggests that early auditory processing is hyper-sensitive in autism whereas later processing of prosodic information is hypo-sensitive. The impact the different sensory profiles have on perceptual experience in autism may be key to identifying behavioral treatments to reduce symptoms.

Autistic Traits and Empathy for Others' Pain Among the General Population: Test of the Mediating Effects of First-Hand Pain Sensitivity

Autism spectrum disorders (ASD) are characterized by reduced pain empathy-a process that is grounded in first-hand pain perception. Because autistic traits are continuously distributed in the general population, we hypothesized that first-hand pain sensitivity would mediate the link between autistic traits and pain empathy. After controlling for alexithymia, higher autistic traits were associated with lower cognitive and emotional empathy in response to others' pain, as well as lower sensitivity to cold and heat pain (higher cold pain tolerance and lower laser heat pain-intensity ratings). Importantly, pain sensitivity fully mediated the link between autistic traits and pain empathy. These findings highlight the role of atypical first-hand pain sensitivity in the lack of pain empathy observed in people with high autistic traits or ASD.

EEG Correlates of Sustained Attention Variability during Discrete Multi-finger Force Control Tasks

The neurophysiological characteristics of sustained attention states are unclear in discrete multi-finger force control tasks. In this article, we developed an immersive visuo-haptic task for conducting stimulus-response measurements. Visual cues were randomly provided to signify the required amplitude and tolerance of fingertip force. Participants were required to respond to the visual cues by pressing force transducers using their fingertips. Response time variation was taken as a behavioral measure of sustained attention states during the task. 50% low-variability trials were classified as the optimal state and the other high-variability trials were classified as the suboptimal state using z-scoring over time. A 64-channel electroencephalogram (EEG) acquisition system was used to collect brain activities during the tasks. The haptics-elicited potential amplitude at 20 ∼ 40 ms in latency and over the frontal-central region significantly decreased in the optimal state. Furthermore, the alpha-band power in the spectra of 8 ∼ 13 Hz was significantly suppressed in the frontal-central, right temporal, and parietal regions in the optimal state. Taken together, we have identified neuroelectrophysiological features that were associated with sustained attention during multi-finger force control tasks, which would be potentially used in the development of closed-loop attention detection and training systems exploiting haptic interaction.

Individual Differences in Negative Emotion Differentiation Predict Resting-State Spontaneous Emotional Regulatory Processes

Negative emotion differentiation facilitates emotion regulation. However, whether individual differences in negative emotion differentiation is associated with resting-state spontaneous emotion regulation remains unclear. This study aimed to explore the effect of individual differences in negative emotion differentiation on spontaneous emotional regulatory processes as indexed by resting electroencephalogram (EEG) indicators (e.g., frontal alpha asymmetry and theta/beta ratio). Participants (n = 40, M_age = 21.74 years, 62% women) completed a negative emotion differentiation task. Afterward, 4 min of resting EEG data were recorded. Multiple regression results showed that negative emotion differentiation significantly predicted the alpha asymmetry at electrode pairs (F4–F3 and FP2–FP1) and the theta/beta ratio at the F3 and FZ electrode sites. Individuals with high negative emotion differentiation presented more left-lateralized activations and a lower theta/beta ratio. Taken together, these results suggest that individuals with high negative emotion differentiation show enhanced spontaneous emotional regulatory functioning. Thus, we provided the first resting-state neural evidence on emotion differentiation of spontaneous emotional regulatory functioning.

Visual similarity and psychological closeness are neurally dissociable in the brain response to vicarious pain

Personal and vicarious experience of pain activate partially overlapping brain networks. This brain activity is further modulated by low- and high-order factors, e.g., the perceived intensity of the model's pain and the model's similarity with the onlooker, respectively. We investigated which specific aspect of similarity modulates such empathic reactivity, focusing on the potential differentiation between visual similarity and psychological closeness between the onlooker and different types of models. To this aim, we recorded fMRI data in neurotypical participants who observed painful and tactile stimuli delivered to an adult human hand, a baby human hand, a puppy dog paw, and an anthropomorphic robotic hand. The interaction between type of vicarious experience (pain, touch) and nature of model (adult, baby, dog, robot) showed that the right supramarginal gyrus (rSMG) was selectively active for visual similarity (more active during vicarious pain for the adult and baby models), while the anterior cingulate cortex (ACC) was more sensitive to psychological closeness (specifically linked to vicarious pain for the baby model). These findings indicate that visual similarity and psychological closeness between onlooker and model differentially affect the activity of brain regions specifically implied in encoding interindividual sharing of sensorimotor and affective aspects of vicarious pain, respectively.

Altered neuronal habituation to hearing others' pain in adults with autistic traits

This study tested the hypothesis that autistic traits influence the neuronal habituation that underlies the processing of others' pain. Based on their autism-spectrum quotient (AQ), two groups of participants were classified according to their autistic traits: High-AQ and Low-AQ groups. Their event-related potentials in response to trains of three identical audio recordings, exhibiting either painful or neutral feelings of others, were compared during three experimental tasks. (1) In a Pain Judgment Task, participants were instructed to focus on pain-related cues in the presented audio recordings. (2) In a Gender Judgment Task, participants were instructed to focus on non-pain-related cues in the presented audio recordings. (3) In a Passive Listening Task, participants were instructed to passively listen. In the High-AQ group, an altered empathic pattern of habituation, indexed by frontal-central P2 responses of the second repeated painful audio recordings, was found during the Passive Listening Task. Nevertheless, both High-AQ and Low-AQ groups exhibited similar patterns of habituation to hearing others' voices, both neutral and painful, in the Pain Judgment and Gender Judgment Tasks. These results suggest altered empathic neuronal habituation in the passive processing of others' vocal pain by individuals with autistic traits.

Can self-pain sensitivity quantify empathy for others' pain?

Empathy is essential for the survival of social species. In many studies, especially those with animal models, empathy for pain was evaluated by the modulation of pain sensitivity. However, the relationship between pain sensitivity and empathy for pain is not well established. Here, by performing two experiments, we aimed to investigate their relationship at both behavioral and electrophysiological levels. In Experiment 1, we characterized individual pain sensitivity using pain threshold and tolerance in a cold pressor test, self-report empathy using Interpersonal Reactivity Index, and pain-related psychological factors, including pain-related anxiety, depression, pain catastrophizing, and pain-related fear, using well-validated questionnaires. We observed that pain sensitivity was positively correlated with emotional empathy, and their relationship was mediated by pain-related anxiety, pain catastrophizing, and pain-related fear. In Experiment 2, we quantified empathy for pain using pain intensity and unpleasantness as well as event-related potentials (ERPs) in an empathy for pain task. Positive correlations were observed between pain sensitivity and psychophysiological empathic responses (i.e., the P3 component and the late positive potential in ERPs), and their relationship was mediated by pain-related fear. These results suggested that being influenced by some pain-related psychological factors, individuals with higher pain sensitivity tended to have stronger empathy for pain, manifested as stronger emotional reactions to others' pain. Our results indicated that the conventional strategy of using pain sensitivity to quantify empathy should be treated with caution, as their relationship could be disturbed by experimental manipulations or pathological modulations that could influence individual emotional states or cognitive processes.

Top-down attention modulation on the perception of others' vocal pain: An event-related potential study

Pain is typically expressed through various sensory (e.g., visual and auditory) modalities: the human voice conveys information about social and affective communication. While the empathic responses to others' pain in the visual modality are modulated by top-down attention constraints, it remains unclear whether empathy for such expressions in the auditory modality also involves such top-down modulation mechanisms. Therefore, the present study investigates how neural correlates of empathic processes to others' vocal pain are modulated by the task-instructed attention manipulations. Each participant completed the following three tasks: (1) Pain Judgment Task, in which participants were instructed to pay attention to pain cues in vocal stimuli, (2) Gender Judgment Task, in which participants were instructed to pay attention to non-pain cues in vocal stimuli; (3) Passive Listening Task, a control task in which participants were instructed to passively listen to the vocal stimuli without any required response. The earlier frontal-central N1 response to either others' painful or neutral voice was greater in the Pain Judgment Task than in the other two tasks, suggesting a general attention modulation on the bottom-up sensory processing of vocal stimuli. The frontal-central P2 responses to others' painful voices was greater in the Pain Judgment Task than in the other two tasks, but not to others' neutral voices, thus suggesting selective attention modulation on the P2 response to others' pain. Late positive complex (LPC) to others' painful and neutral voices differed significantly regardless of task manipulations, thus suggesting empathic pain modulation on LPC response. All these results demonstrated top-down attention modulation on affective sharing responses others' vocal pain, but not on cognitive appraisal process of others' vocal pain.