Effects of pseudoexperience on the understanding of hemiplegic movements in physical therapists: An fMRI study

Imitation encourages empathic capacity toward other individuals with physical disabilities

Many people have difficulty empathizing with others who have dissimilar characteristics, such as physical disabilities. We hypothesized that people with no disabilities imitating the movements of individuals with disabilities could improve the empathic capacity toward their difficulties. To evaluate this hypothesis, we used functional magnetic resonance imaging to measure the neural activity patterns of 26 healthy participants while they felt the difficulties of individuals with hemiplegia by adopting their perspective. The participants initially either imitated or observed hemiplegic hand movements shown in video clips. Subsequently, the videos were rewatched and their difficulties were rated. Analysis of the subjective rating scores indicated that after imitating the hemiplegic movements, the participants felt into the difficulties of hemiplegia better than if they simply observed them. The cross-validation approach of multivoxel pattern analyses demonstrated that the information regarding the effect of imitation on empathizing with the difficulties was represented in specific activation patterns of brain regions involved in the mirror neuron system and cognitive empathy by comparing to other conditions that did not contain the information. The cross-classification approach detected distinct activation patterns in the brain regions involved in affective and cognitive empathy, commonly while imitating the hemiplegic movements and subsequently feeling them. This indicated that the common representation related to these two types of empathy existed between imitating and feeling the hemiplegic movements. Furthermore, representational similarity analysis revealed that activity patterns in the anterior cingulate cortex linked to affective empathy tuned to the subjective assessment of hemiplegic movements. Our findings indicate that imitating the movements of individuals with hemiplegia triggered the affective empathic response and improved the cognitive empathic response toward them. The affective empathic response also linked the subjective assessment to the difficulties of hemiplegia, which was especially modulated by the experience of imitation. Imitating the movements of individuals with disabilities likely encourages empathic capacity from both affective and cognitive aspects, resulting in people with no disabilities precisely feeling what they are feeling.

Meta-analysis of functional neuroimaging and dispositional variables for clinical empathy

Clinical empathy refers to the ability of healthcare providers (HP) to recognize and understand what patients feel. While neuroimaging investigations have identified a neural network of empathy, activation consistency of brain regions and their specific functions in clinical empathy remains unclear. Herein, we conducted meta-analyses of dispositional assessments using random-effects models and functional neuroimaging using Seed-based d Mapping with Permutation of Subject Images to ascertain the shared neural processes consistently identified as relevant to clinical empathy. The dispositional meta-analysis (n = 15) revealed that HP exhibited higher scores on empathic concern and perspective taking. The HP neuroimaging meta-analysis (n = 11) identified consistent activation of the anterior mid-cingulate cortex, anterior insula, and ventrolateral prefrontal cortex (vlPFC) while HP vs. controls comparison (n = 9) did not yield robust alterations. The vlPFC mediated positive and negative functional connectivity of the insula. We revisited the framework of emotion regulation in clinical empathy. The empathetic agent flexibly shifts between affective regulatory strategies to meet contextual demands, with vlPFC figuring as the key region where this neural mechanism takes place.

First-person perspective sharpens the understanding of distressful physical feelings associated with physical disability: A functional magnetic resonance study

We investigated whether observation of hand movements of people with hemiplegia by healthy individuals from the first-person perspective (FPP), compared to that from the third-person perspective (TPP), enables better understanding of disability-associated distress. We measured the neural activity of healthy individuals using functional magnetic resonance imaging while they observed hemiplegic movements from the FPP or TPP. Subjective assessment of the movements was determined with questionnaires. Compared to the TPP, the FPP elicited stronger activation in the inferior parietal lobule (IPL), right temporoparietal junction, and anterior cingulate cortex, which are associated with body representation, mentalization, and empathy, respectively. Enhanced IPL activity correlated positively with personal empathic traits. Observing movements of hemiplegic individuals from the FPP provided precise subjective understanding of the physically distressing aspects of their movements. These findings suggest that observing hemiplegic individuals from the FPP effectively improved observers' understanding of disability-associated distress via body representation, mentalization, and empathy systems.