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Kimmig ACS, Burger L, Schall M, Derntl B, Wildgruber D. Impairment of affective and cognitive empathy in high functioning autism is mediated by alterations in emotional reactivity. Sci Rep 2024; 14:21662. [PMID: 39289415 PMCID: PMC11408716 DOI: 10.1038/s41598-024-71825-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 08/30/2024] [Indexed: 09/19/2024] Open
Abstract
Empathy impairments are considered a key aspect of autism-spectrum disorders (ASD). Previous research consistently shows reduced cognitive empathy, but findings on affective empathy vary, possibly due to experimental design variations (e.g., stimulus modality, social distance) and individual psychological factors (e.g., perceptual abilities, emotional reactivity). This study aims to clarify deficits in affective and cognitive empathy in ASD by addressing these contributing factors. Empathy was examined in 34 autistic individuals and 33 typically developed controls (TDCs) through the Textual Empathy Test (TET). The TET was developed to assess emotional responses when imagining oneself (emotional reactivity) as compared to a target person (friend, stranger) in emotional situations presented via short verbal descriptions. Participants rated emotional states of the target person (cognitive empathy) as well as their own emotional responses when imagining the target person in that situation (affective empathy). Ratings were interpreted relative to normative mean values through standardized regression coefficients. Results showed that high-functioning autism was associated with lower cognitive and affective empathy irrespective of social distance as well as with decreased emotional reactivity compared to controls. Moreover, emotional reactivity mediated the impact of ASD on both empathic components. In summary, altered emotional reactivity may underlie impaired empathy in autistic individuals.
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Affiliation(s)
- Ann-Christin S Kimmig
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstr. 14, 72076, Tübingen, Germany.
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany.
| | - Lina Burger
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstr. 14, 72076, Tübingen, Germany
| | - Marina Schall
- Department of Psychology, University of Bamberg, Bamberg, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstr. 14, 72076, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstr. 14, 72076, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
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Bögl K, Bayer M, Walter H, Dziobek I. Influences of heart rate feedback and autistic traits on affective mindreading. Sci Rep 2024; 14:18783. [PMID: 39138278 PMCID: PMC11322188 DOI: 10.1038/s41598-024-69038-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/30/2024] [Indexed: 08/15/2024] Open
Abstract
Although mindreading is an important prerequisite for successful social interactions, the underlying mechanisms are still matter of debate. It is unclear, for example, if inferring others' and own mental states are distinct processes or are based on a common mechanism. Using an affect-induction experimental set-up with an acoustic heart rate feedback that addresses affective mindreading in self and others, we investigated if non-autistic study participants relied on similar information for self- and other-directed mindreading. We assumed that due to altered mindreading capacities in autism, mainly individuals with low autistic traits would focus on additional sensory cues, such as heart rate, to infer their own and their gambling partner's affective states. Our analyses showed that the interpretation of a heart rate signal differed in self- and other-directed mindreading trials. This effect was modulated by autistic traits suggesting that individuals with higher autistic traits might not have interpreted the heart rate feedback for gambling partner ratings and differentiated less between self- and other-directed mindreading trials. We discuss these results in the context of a common mechanism underlying self- and other-directed mindreading and hypothesize that the weighting of internal and external sensory information might contribute to how we make sense of our and others' mental states.
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Affiliation(s)
- Katharina Bögl
- Clinical Psychology of Social Interaction, Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Mareike Bayer
- Clinical Psychology of Social Interaction, Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
| | - Henrik Walter
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of FU Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Isabel Dziobek
- Clinical Psychology of Social Interaction, Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
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Di Tella M, Benfante A, Castelli L, Adenzato M, Ardito RB. On the Relationship Between Alexithymia and Social Cognition: A Systematic Review. CLINICAL NEUROPSYCHIATRY 2024; 21:236-265. [PMID: 39309025 PMCID: PMC11411512 DOI: 10.36131/cnfioritieditore20240402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Objective This systematic review summarises the studies that have investigated the relationship between dimensions of social cognition (i.e., Theory of Mind - ToM, emotion recognition, and empathy) and alexithymia in the general adult non-clinical population. Method PubMed, PsycINFO, and Scopus databases were screened, using the following strings: ("alexithymi*") AND ("theory of mind" OR "ToM"); ("alexithymi*") AND ("empath*"); ("alexithymi*") AND ("emotion recognition"); ("alexithymi*") AND ("social cognition"). Results A total of 117 studies met the inclusion criteria and were included in this review. The total number of participants included in the reviewed studies was 40,231. Mixed results were found for alexithymia and ToM, while the relationship between emotion recognition or empathy and alexithymia was more homogeneous. Alexithymia was found to be significantly associated with both a reduced ability to recognise emotions and empathy. Conclusions These results support the existence of significant relationships between alexithymia and altered social cognitive abilities. Future research is needed to confirm the present findings and further elucidate the complex relationship between these processes. Suggestions are made on how to overcome some of the theoretical and methodological problems in the literature.
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Affiliation(s)
- Marialaura Di Tella
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Agata Benfante
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Mauro Adenzato
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Rita B. Ardito
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
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Le B, Huang Y, Wang L, Hu H, Wang X, Wang Y, Wang Y, Huang J, Lui SSY, Chan RCK. Individuals with high levels of autistic traits exhibit impaired cognitive but not affective theory of mind and empathy. Psych J 2024; 13:486-493. [PMID: 38298152 PMCID: PMC11169754 DOI: 10.1002/pchj.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/15/2023] [Indexed: 02/02/2024]
Abstract
Theory of mind (ToM) and empathy are considered key components of social cognition that are often impaired in individuals with autism spectrum disorders (ASD). However, it remains unclear whether individuals with high levels of autistic traits exhibit similar impairments in these two functions. This study examined the affective and cognitive domains of ToM and empathy in individuals with high levels of autistic traits. We recruited 84 participants with high levels and 78 participants with low levels of autistic traits to complete a set of self-reported checklists and performance-based tasks capturing affective and cognitive components of ToM and empathy. The results showed that participants with high levels of autistic traits exhibited significant impairments in cognitive but not in affective ToM and empathy compared with their counterparts with low levels of autistic traits. We also found that empathy impairments in people with high levels of autistic traits were confounded by alexithymia and depressive traits.
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Affiliation(s)
- Bei‐lin Le
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Yi‐hang Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Ling‐ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Hui‐xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Xuan Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Simon S. Y. Lui
- Department of Psychiatry, School of Clinical MedicineThe University of Hong KongHong Kong Special Administrative RegionChina
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
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Petrosini L, Picerni E, Termine A, Fabrizio C, Laricchiuta D, Cutuli D. The Cerebellum as an Embodying Machine. Neuroscientist 2024; 30:229-246. [PMID: 36052895 DOI: 10.1177/10738584221120187] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Whereas emotion theorists often keep their distance from the embodied approach, theorists of embodiment tend to treat emotion as a mainly physiologic process. However, intimate links between emotions and the body suggest that emotions are privileged phenomena to attempt to reintegrate mind and body and that the body helps the mind in shaping emotional responses. To date, research has favored the cerebrum over other parts of the brain as a substrate of embodied emotions. However, given the widely demonstrated contribution of the cerebellum to emotional processing, research in affective neuroscience should consider embodiment theory as a useful approach for evaluating the cerebellar role in emotion and affect. The aim of this review is to insert the cerebellum among the structures needed to embody emotions, providing illustrative examples of cerebellar involvement in embodied emotions (as occurring in empathic abilities) and in impaired identification and expression of embodied emotions (as occurring in alexithymia).
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Affiliation(s)
| | | | | | | | | | - Debora Cutuli
- Santa Lucia Foundation IRCCS, Rome, Italy
- Department of Psychology, University Sapienza of Rome, Rome, Italy
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Tkalcec A, Bierlein M, Seeger-Schneider G, Walitza S, Jenny B, Menks WM, Felhbaum LV, Borbas R, Cole DM, Raschle N, Herbrecht E, Stadler C, Cubillo A. Empathy deficits, callous-unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth. Autism Res 2023; 16:1946-1962. [PMID: 37548142 DOI: 10.1002/aur.2993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023]
Abstract
Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous-Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel-Based Morphometry with Threshold-Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent-reported AE and CE scores and lower self-reported CE scores while the CD group showed lower parent-reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co-occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder-specific. Investigating the subdimensions of empathy may therefore help to identify disorder-specific empathy deficits.
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Affiliation(s)
- Antonia Tkalcec
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Maria Bierlein
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Gudrun Seeger-Schneider
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Bettina Jenny
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Willeke M Menks
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, and Radboud University Medical Centre, Nijmegen, the Netherlands
- Psychology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Lynn V Felhbaum
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Reka Borbas
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - David M Cole
- Translational Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Nora Raschle
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Evelyn Herbrecht
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Christina Stadler
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Ana Cubillo
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
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Shalev I, Eran A, Uzefovsky F. Empathic disequilibrium as a new framework for understanding individual differences in psychopathology. Front Psychol 2023; 14:1153447. [PMID: 37275732 PMCID: PMC10236526 DOI: 10.3389/fpsyg.2023.1153447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/05/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Empathy is part of basic social cognition and is central to everyday interactions. Indeed, emotional and cognitive empathy deficits are related to various psychopathologies, yet the links reported have been inconsistent. Thus, the mechanism underlying these inconsistent links is poorly understood. At least a partial answer may lie in that the dependency between cognitive and emotional empathy has been overlooked. Here, we examined the (dis)equilibrium between emotional and cognitive empathy and how it relates to individual differences in clinical traits. We further examined a possible mediator of these links-emotional reactivity. Methods Participants (N = 425) from the general population reported on their empathy, emotional reactivity, autistic traits, psychopathic tendencies, and symptoms of depression and anxiety. Results Beyond empathy, both extremes of empathic disequilibrium were associated with various features of clinical conditions; Higher emotional relative to cognitive empathy was related to the social domain of autism and anxiety, while higher cognitive relative to emotional empathy was related to the non-social domain of autism, depression symptoms, and psychopathic tendencies. The associations with autistic traits, anxiety, and psychopathic tendencies were mediated by emotional reactivity. Discussion Our findings suggest a new framework for understanding how individual variability in empathy is expressed in various psychopathologies.
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Affiliation(s)
- Ido Shalev
- Psychology Department, Ben Gurion University, Beer-Sheba, Israel
| | - Alal Eran
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States
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Bollen C. A reflective guide on the meaning of empathy in autism research. METHODS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.metip.2022.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Shalev I, Warrier V, Greenberg DM, Smith P, Allison C, Baron‐Cohen S, Eran A, Uzefovsky F. Reexamining empathy in autism: Empathic disequilibrium as a novel predictor of autism diagnosis and autistic traits. Autism Res 2022; 15:1917-1928. [PMID: 36053924 PMCID: PMC9804307 DOI: 10.1002/aur.2794] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/08/2022] [Indexed: 01/07/2023]
Abstract
A large body of research showed that autistic people have intact emotional (affective) empathy alongside reduced cognitive empathy. However, there are mixed findings and these call for a more subtle understanding of empathy in autism. Empathic disequilibrium refers to the imbalance between emotional and cognitive empathy and is associated with a higher number of autistic traits in the typical population. Here we examined whether empathic disequilibrium predicts both the number of autistic traits and autism diagnosis. In a large sample of autistic (N = 1905) and typical individuals (N = 3009), we examined empathic disequilibrium and empathy as predictors of autistic traits and autism diagnosis, using a polynomial regression with response surface analysis. Empathy and autistic traits were measured using validated self-report questionnaires. Both empathic disequilibrium and empathy predicted linearly and non-linearly autism diagnosis and autistic traits. Specifically, a tendency towards higher emotional than cognitive empathy (empathic disequilibrium towards emotional empathy) predicted both autism diagnosis and the social domain of autistic traits, while higher cognitive than emotional empathy was associated with the non-social domain of autism. Empathic disequilibrium was also more prominent in autistic females. This study provides evidence that beyond empathy as was measured thus far, empathic disequilibrium offers a novel analytical approach for examining the role of empathy. Empathic disequilibrium allows for a more nuanced understanding of the links between empathy and autism. LAY SUMMARY: Many autistic individuals report feelings of excessive empathy, yet their experience is not reflected by most of the current literature, typically suggesting that autism is characterized by intact emotional and reduced cognitive empathy. To fill this gap, we looked at both ends of the imbalance between these components, termed empathic disequilibrium. We show that, like empathy, empathic disequilibrium is related to autism diagnosis and traits, and thus may provide a more nuanced understanding of empathy and its link with autism.
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Affiliation(s)
- Ido Shalev
- Psychology DepartmentBen Gurion University of the NegevBeer‐ShebaIsrael,Zlotowski Center for NeuroscienceBen Gurion University of the NegevBeer‐ShebaIsrael
| | - Varun Warrier
- Department of Psychiatry, Autism Research CentreUniversity of CambridgeCambridgeUK
| | - David M. Greenberg
- Department of Psychiatry, Autism Research CentreUniversity of CambridgeCambridgeUK,Interdisciplinary Department of Social Sciences and Department of MusicBar‐Ilan UniversityRamat GanIsrael
| | - Paula Smith
- Department of Psychiatry, Autism Research CentreUniversity of CambridgeCambridgeUK
| | - Carrie Allison
- Department of Psychiatry, Autism Research CentreUniversity of CambridgeCambridgeUK
| | - Simon Baron‐Cohen
- Department of Psychiatry, Autism Research CentreUniversity of CambridgeCambridgeUK
| | - Alal Eran
- Zlotowski Center for NeuroscienceBen Gurion University of the NegevBeer‐ShebaIsrael,Life Sciences DepartmentBen Gurion University of the NegevBeer‐ShebaIsrael,Computational Health Informatics ProgramBoston Children's HospitalBostonMassachusettsUSA
| | - Florina Uzefovsky
- Psychology DepartmentBen Gurion University of the NegevBeer‐ShebaIsrael,Zlotowski Center for NeuroscienceBen Gurion University of the NegevBeer‐ShebaIsrael
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Cerebellum, Embodied Emotions, and Psychological Traits. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:255-269. [DOI: 10.1007/978-3-030-99550-8_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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11
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Macro- and micro-structural cerebellar and cortical characteristics of cognitive empathy towards fictional characters in healthy individuals. Sci Rep 2021; 11:8804. [PMID: 33888760 PMCID: PMC8062506 DOI: 10.1038/s41598-021-87861-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/31/2021] [Indexed: 12/21/2022] Open
Abstract
Few investigations have analyzed the neuroanatomical substrate of empathic capacities in healthy subjects, and most of them have neglected the potential involvement of cerebellar structures. The main aim of the present study was to investigate the associations between bilateral cerebellar macro- and micro-structural measures and levels of cognitive and affective trait empathy (measured by Interpersonal Reactivity Index, IRI) in a sample of 70 healthy subjects of both sexes. We also estimated morphometric variations of cerebral Gray Matter structures, to ascertain whether the potential empathy-related peculiarities in cerebellar areas were accompanied by structural differences in other cerebral regions. At macro-structural level, the volumetric differences were analyzed by Voxel-Based Morphometry (VBM)- and Region of Interest (ROI)-based approaches, and at a micro-structural level, we analyzed Diffusion Tensor Imaging (DTI) data, focusing in particular on Mean Diffusivity and Fractional Anisotropy. Fantasy IRI-subscale was found to be positively associated with volumes in right cerebellar Crus 2 and pars triangularis of inferior frontal gyrus. The here described morphological variations of cerebellar Crus 2 and pars triangularis allow to extend the traditional cortico-centric view of cognitive empathy to the cerebellar regions and indicate that in empathizing with fictional characters the cerebellar and frontal areas are co-recruited.
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