Neural measures of the role of affective prosody in empathy for pain

The vocal side of empathy: neural correlates of pain perception in spoken complaints

In the extensive neuroimaging literature on empathy for pain, few studies have investigated how this phenomenon may relate to everyday social situations such as spoken interactions. The present study used functional Magnetic Resonance Imaging (fMRI) to assess how complaints, as vocal expressions of pain, are empathically processed by listeners and how these empathic responses may vary based on speakers' vocal expression and cultural identity. Twenty-four French participants listened to short utterances describing a painful event, which were either produced in a neutral-sounding or complaining voice by both in-group (French) and out-group (French Canadian) speakers. Results suggest that the perception of suffering from a complaining voice increased activity in the emotional voice areas, composed of voice-sensitive temporal regions interacting with prefrontal cortices and the amygdala. The Salience and Theory of Mind networks, associated with affective and cognitive aspects of empathy, also showed prosody-related activity and specifically correlated with behavioral evaluations of suffering by listeners. Complaints produced by in- vs out-group speakers elicited sensorimotor and default mode activity, respectively, suggesting accent-based changes in empathic perspective. These results, while reaffirming the role of key networks in tasks involving empathy, highlight the importance of vocal expression information and social categorization processes when perceiving another's suffering during social interactions.

Electrophysiological correlates of semantic pain processing in the affective priming

Introduction

Pain plays a fundamental role in the well-being of the individual, and its semantic content may have specific properties compared to other negative domains (i.e., fear and anger) which allows the cognitive system to detect it with priority. Considering the influence of the affective context in which stimuli (targets) are evaluated, it is possible that their valence could be differentially processed if preceded by negative stimuli (primes) associated with pain than negative stimuli not associated with pain. Thus, the present study aims to investigate the electrophysiological correlates of the implicit processing of words with pain content by using an affective priming paradigm.

Methods

Event-related potentials (ERPs) were recorded while participants were presented with positive and negative word targets (not associated with pain) that were preceded by positive, negative (not associated with pain), and pain word primes. Participants were asked to judge the valence of the target word.

Results

Results showed faster reaction times (RTs) in congruent conditions, especially when the negative target was preceded by a pain prime rather than a positive one. ERPs analyses showed no effect of pain at an early-stage processing (N400), but a larger waveform when the pain prime preceded the positive prime on the LPP.

Discussion

These results reaffirm the importance that valence has in establishing the priority with which stimuli are encoded in the environment and highlight the role that pain has in the processing of stimuli, supporting the hypothesis according to which the valence and the semantics of a stimulus interact with each other generating a specific response for each type of emotion.

Complain like you mean it! How prosody conveys suffering even about innocuous events

When complaining, speakers can use their voice to convey a feeling of pain, even when describing innocuous events. Rapid detection of emotive and identity features of the voice may constrain how the semantic content of complaints is processed, as indexed by N400 and P600 effects evoked by the final, pain-related word. Twenty-six participants listened to statements describing painful and innocuous events expressed in a neutral or complaining voice, produced by ingroup and outgroup accented speakers. Participants evaluated how hurt the speaker felt under EEG monitoring. Principal Component Analysis of Event-Related Potentials from the final word onset demonstrated N400 and P600 increases when complainers described innocuous vs. painful events in a neutral voice, but these effects were altered when utterances were expressed in a complaining voice. Independent of prosody, N400 amplitudes increased for complaints spoken in outgroup vs. ingroup accents. Results demonstrate that prosody and accent constrain the processing of spoken complaints as proposed in a parallel-constraint-satisfaction model.

Fading boundaries between the physical and the social world: Insights and novel techniques from the intersection of these two fields

This review focuses on the subtle interactions between sensory input and social cognition in visual perception. We suggest that body indices, such as gait and posture, can mediate such interactions. Recent trends in cognitive research are trying to overcome approaches that define perception as stimulus-centered and are pointing toward a more embodied agent-dependent perspective. According to this view, perception is a constructive process in which sensory inputs and motivational systems contribute to building an image of the external world. A key notion emerging from new theories on perception is that the body plays a critical role in shaping our perception. Depending on our arm's length, height and capacity of movement, we create our own image of the world based on a continuous compromise between sensory inputs and expected behavior. We use our bodies as natural "rulers" to measure both the physical and the social world around us. We point out the necessity of an integrative approach in cognitive research that takes into account the interplay between social and perceptual dimensions. To this end, we review long-established and novel techniques aimed at measuring bodily states and movements, and their perception, with the assumption that only by combining the study of visual perception and social cognition can we deepen our understanding of both fields.

Listen to my feelings! How prosody and accent drive the empathic relevance of complaining speech

Interpersonal communication often involves sharing our feelings with others; complaining, for example, aims to elicit empathy in listeners by vocally expressing a speaker's suffering. Despite the growing neuroscientific interest in the phenomenon of empathy, few have investigated how it is elicited in real time by vocal signals (prosody), and how this might be affected by interpersonal factors, such as a speaker's cultural background (based on their accent). To investigate the neural processes at play when hearing spoken complaints, twenty-six French participants listened to complaining and neutral utterances produced by in-group French and out-group Québécois (i.e., French-Canadian) speakers. Participants rated how hurt the speaker felt while their cerebral activity was monitored with electroencephalography (EEG). Principal Component Analysis of Event-Related Potentials (ERPs) taken at utterance onset showed culture-dependent time courses of emotive prosody processing. The high motivational relevance of ingroup complaints increased the P200 response compared to all other utterance types; in contrast, outgroup complaints selectively elicited an early posterior negativity in the same time window, followed by an increased N400 (due to ongoing effort to derive affective meaning from outgroup voices). Ingroup neutral utterances evoked a late negativity which may reflect re-analysis of emotively less salient, but culturally relevant ingroup speech. Results highlight the time-course of neurocognitive responses that contribute to emotive speech processing for complaints, establishing the critical role of prosody as well as social-relational factors (i.e., cultural identity) on how listeners are likely to "empathize" with a speaker.

Verbal Suggestion Modulates the Sense of Ownership and Heat Pain Threshold During the "Injured" Rubber Hand Illusion

The appearance of the self-body influences the feeling that one's body belongs to oneself, that is, a sense of ownership (SoO) and pain perception. This can be identified by measuring the SoO and pain thresholds after performing the rubber hand illusion (RHI) with an injured rubber hand. The generation of SoO is thought to be caused by multisensory integration of bottom-up factors (vision, proprioceptive, and touch), and by top-down factors, such as the context effect. The appearance is one of the context effects which may become more effective when used simultaneously with other context effects (e.g., verbal suggestion). However, in the RHI, when appearance and other context effects are used simultaneously, the effect is unclear. In this study, we attempted to identify the influence of verbal suggestion on the SoO and heat pain threshold (HPT). As a preliminary step, in Experiment 1, the "normal" rubber hand and "penetrated nail" as injured rubber hand were used to clarify the context effect with appearance alone during RHI (synchronous/asynchronous), which was conducted within-subjects. In Experiment 2, we only used the "penetrated nail" rubber hand to clarify the context effect with verbal suggestion and appearance during RHI. We randomly classified participants into two suggestion groups ("fear" and "no-fear"). The RHI (synchronous/asynchronous) was conducted for each group. In each experiment, the effect of each condition was assessed by subjective measures of SoO, such as questionnaire, and objective measures of SoO, such as proprioceptive drift and electrodermal activity. Following RHI in each condition, HPT was measured. The main finding was that, in the synchronous condition, the "penetrated nail" appearance with "fear" verbal suggestion modulated questionnaire and HPT, but not electrodermal activity. We conclude that the context-included multisensory integration affected the subjective factors because it contains a higher cognitive process by verbal suggestion.

Remember as we empathize. Do brain mechanisms engaged in autobiographical memory retrieval causally affect empathy awareness? A combined TMS and EEG registered report

Social interactions are partly driven by our ability to empathize-the capacity to share and understand others' inner states. While a growing body of evidence suggests a link between past experiences and empathy, to what degree empathy is dependent on our own previous experiences (autobiographical memories, AMs) is still unclear. Whereas neuroimaging studies have shown wide overlapping brain networks underpinning AM and empathic processes, studies on clinical populations with memory loss have not always shown empathy is impaired. The current transcranial magnetic stimulation (TMS) and electroencephalography study will seek to shed light on this neuropsychological puzzle by testing whether self-perceived empathy is causally linked to AM retrieval. Cortical activity, together with self-rating of empathy, will be recorded for scenarios that echo personal experiences while a brain region critical for AM retrieval will be transiently inhibited using TMS before task performance.

EEG and fMRI evidence for autobiographical memory reactivation in empathy

Empathy relies on the ability to mirror and to explicitly infer others' inner states. Theoretical accounts suggest that memories play a role in empathy, but direct evidence of reactivation of autobiographical memories (AM) in empathy is yet to be shown. We addressed this question in two experiments. In Experiment 1, electrophysiological activity (EEG) was recorded from 28 participants. Participants performed an empathy task in which targets for empathy were depicted in contexts for which participants either did or did not have an AM, followed by a task that explicitly required memory retrieval of the AM and non‐AM contexts. The retrieval task was implemented to extract the neural fingerprints of AM and non‐AM contexts, which were then used to probe data from the empathy task. An EEG pattern classifier was trained and tested across tasks and showed evidence for AM reactivation when participants were preparing their judgement in the empathy task. Participants self‐reported higher empathy for people depicted in situations they had experienced themselves as compared to situations they had not experienced. A second independent fMRI experiment replicated this behavioural finding and showed increased activation for AM compared to non‐AM in the brain networks underlying empathy: precuneus, posterior parietal cortex, superior and inferior parietal lobule, and superior frontal gyrus. Together, our study reports behavioural, electrophysiological, and fMRI evidence that robustly supports AM reactivation in empathy.

Emotivity in the Voice: Prosodic, Lexical, and Cultural Appraisal of Complaining Speech

Emotive speech is a social act in which a speaker displays emotional signals with a specific intention; in the case of third-party complaints, this intention is to elicit empathy in the listener. The present study assessed how the emotivity of complaints was perceived in various conditions. Participants listened to short statements describing painful or neutral situations, spoken with a complaining or neutral prosody, and evaluated how complaining the speaker sounded. In addition to manipulating features of the message, social-affiliative factors which could influence complaint perception were varied by adopting a cross-cultural design: participants were either Québécois (French Canadian) or French and listened to utterances expressed by both cultural groups. The presence of a complaining tone of voice had the largest effect on participant evaluations, while the nature of statements had a significant, but smaller influence. Marginal effects of culture on explicit evaluation of complaints were found. A multiple mediation analysis suggested that mean fundamental frequency was the main prosodic signal that participants relied on to detect complaints, though most of the prosody effect could not be linearly explained by acoustic parameters. These results highlight a tacit agreement between speaker and listener: what characterizes a complaint is how it is said (i.e., the tone of voice), more than what it is about or who produces it. More generally, the study emphasizes the central importance of prosody in expressive speech acts such as complaints, which are designed to strengthen social bonds and supportive responses in interactive behavior. This intentional and interpersonal aspect in the communication of emotions needs to be further considered in research on affect and communication.

Enhanced Neural Empathic Responses in Patients with Spino-Bulbar Muscular Atrophy: An Electrophysiological Study

BACKGROUND

Spino-bulbar muscular atrophy is a rare genetic X-linked disease caused by testosterone insensitivity. An inverse correlation has been described between testosterone levels and empathic responses. The present study explored the profile of neural empathic responding in spino-bulbar muscular atrophy patients.

METHODS

Eighteen patients with spino-bulbar muscular atrophy and eighteen healthy male controls were enrolled in the study. Their event-related potentials were recorded during an "Empathy Task" designed to distinguish neural responses linked with experience-sharing (early response) and mentalizing (late response) components of empathy. The task involved the presentation of contextual information (painful vs. neutral sentences) and facial expressions (painful vs. neutral). An explicit dispositional empathy-related questionnaire was also administered to all participants, who were screened via neuropsychological battery tests that did not reveal potential cognitive deficits. Due to electrophysiological artefacts, data from 12 patients and 17 controls were finally included in the analyses.

RESULTS

Although patients and controls did not differ in terms of dispositional, explicit empathic self-ratings, notably conservative event-related potentials analyses (i.e., spatio-temporal permutation cluster analyses) showed a significantly greater experience-sharing neural response in patients compared to healthy controls in the Empathy-task when both contextual information and facial expressions were painful.

CONCLUSION

The present study contributes to the characterization of the psychological profile of patients with spino-bulbar muscular atrophy, highlighting the peculiarities in enhanced neural responses underlying empathic reactions.

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.

Neural measures of the causal role of observers' facial mimicry on visual working memory for facial expressions

Simulation models of facial expressions propose that sensorimotor regions may increase the clarity of facial expressions representations in extrastriate areas. We monitored the event-related potential marker of visual working memory (VWM) representations, namely the sustained posterior contralateral negativity (SPCN), also termed contralateral delay activity, while participants performed a change detection task including to-be-memorized faces with different intensities of anger. In one condition participants could freely use their facial mimicry during the encoding/VWM maintenance of the faces while in a different condition participants had their facial mimicry blocked by a gel. Notably, SPCN amplitude was reduced for faces in the blocked mimicry condition when compared to the free mimicry condition. This modulation interacted with the empathy levels of participants such that only participants with medium-high empathy scores showed such reduction of the SPCN amplitude when their mimicry was blocked. The SPCN amplitude was larger for full expressions when compared to neutral and subtle expressions, while subtle expressions elicited lower SPCN amplitudes than neutral faces. These findings provide evidence of a functional link between mimicry and VWM for faces and further shed light on how this memory system may receive feedbacks from sensorimotor regions during the processing of facial expressions.

Changing characteristics of the empathic communication network after empathy-enhancement program for medical students

The Empathy-Enhancement Program for Medical Students (EEPMS) comprises five consecutive weekly sessions and aims to improve medical students' empathic ability, an essential component of humanistic medical professionalism. Using a graph theory approach for the Ising network (based on l1-regularized logistic regression) comprising emotional regulation, empathic understanding of others' emotion, and emotional expressivity, this study aimed to identify the central components or hubs of empathic communication and the changed profile of integration among these hubs after the EEPMS. Forty medical students participated in the EEPMS and completed the Depression Anxiety Stress Scale-21, the Empathy Quotient-Short Form, the Jefferson Scale of Empathy, and the Emotional Expressiveness Scale at baseline and after the EEPMS. The Ising model-based network of empathic communication was retrieved separately at two time points. Agitation, self-efficacy for predicting others' feelings, emotional concealment, active emotional expression, and emotional leakage ranked in the top 20% in terms of nodal strength and betweenness and closeness centralities, and they became hubs. After the EEPMS, the 'intentional emotional expressivity' component became less locally segregated (P = 0.014) and more directly integrated into those five hubs. This study shows how to quantitatively describe the qualitative item-level effects of the EEPMS. The key role of agitation in the network highlights the importance of stress management in preserving the capacity for empathic communication. The training effect of EEPMS, shown by the reduced local segregation and enhanced integration of 'intentional emotional expressivity' with hubs, suggests that the EEPMS could enable medical students to develop competency in emotional expression, which is an essential component of empathic communication.