The effects of prior pain experience on neural correlates of empathy for pain: An fMRI study

Neuroimaging studies have revealed partially shared neural substrates for both the actual experience of pain and empathy elicited by the pain of others. We examined whether prior pain exposure increased neural activity in the anterior midcingulate cortex (aMCC) and bilateral anterior insula (AI) as a correlate of empathy for pain. Participants (N = 64: 32 women, 32 men) viewed pictures displaying exposure to pressure pain (pain pictures) and pictures without any cue of pain (neutral pictures). Prior to the experiment, half of the participants were exposed to the same pain stimulus as the one seen in the pain pictures (pain exposure condition); the other half had no such experience (touch exposure condition). A balanced sex ratio was kept, to investigate possible sex differences. In the region-of-interest analyses, participants of the pain exposure condition showed decreased activity in the right AI and the aMCC relative to participants of the touch exposure condition. While in men, no differences were found in relation to their exposure condition, women with pain exposure showed decreased activity in the aMCC and additionally, in bilateral AI. Based on the entire sample, whole brain analyses revealed stronger activation in the retrosplenial cortex, dorsomedial prefrontal cortex, and medial prefrontal cortex in the pain exposure condition. In conclusion, prior pain exposure did not increase, but decreased activity in regions regularly associated with empathy for pain. However, pain experience increased activity in regions associated with memory retrieval, perspective taking, and top-down emotion regulation, which might facilitate empathizing with others.