Department of Psychology, Peking University, 5 Yiheyuan Road, Beijing 100871, China.
Hum Brain Mapp. 2012 Nov;33(11):2666-85. doi: 10.1002/hbm.21392. Epub 2011 Oct 13.
Somatoform disorder patients suffer from impaired emotion recognition and other emotional deficits. Emotional empathy refers to the understanding and sharing of emotions of others in social contexts. It is likely that the emotional deficits of somatoform disorder patients are linked to disturbed empathic abilities; however, little is known so far about empathic deficits of somatoform patients and the underlying neural mechanisms. We used fMRI and an empathy paradigm to investigate 20 somatoform disorder patients and 20 healthy controls. The empathy paradigm contained facial pictures expressing anger, joy, disgust, and a neutral emotional state; a control condition contained unrecognizable stimuli. In addition, questionnaires testing for somatization, alexithymia, depression, empathy, and emotion recognition were applied. Behavioral results confirmed impaired emotion recognition in somatoform disorder and indicated a rather distinct pattern of empathic deficits of somatoform patients with specific difficulties in "empathic distress." In addition, somatoform patients revealed brain areas with diminished activity in the contrasts "all emotions"-"control," "anger"-"control," and "joy"-"control," whereas we did not find brain areas with altered activity in the contrasts "disgust"-"control" and "neutral"-"control." Significant clusters with less activity in somatoform patients included the bilateral parahippocampal gyrus, the left amygdala, the left postcentral gyrus, the left superior temporal gyrus, the left posterior insula, and the bilateral cerebellum. These findings indicate that disturbed emotional empathy of somatoform disorder patients is linked to impaired emotion recognition and abnormal activity of brain regions responsible for emotional evaluation, emotional memory, and emotion generation.
躯体形式障碍患者存在情绪识别等情绪缺陷。情绪共情是指在社会情境中理解和分享他人的情绪。躯体形式障碍患者的情绪缺陷可能与共情能力受损有关；然而，目前对于躯体形式障碍患者的共情缺陷及其潜在的神经机制知之甚少。我们使用 fMRI 和共情范式来研究 20 名躯体形式障碍患者和 20 名健康对照者。共情范式包含表达愤怒、喜悦、厌恶和中性情绪的面部图片；对照条件包含无法识别的刺激。此外，还应用了躯体化、述情障碍、抑郁、共情和情绪识别的问卷进行测试。行为结果证实了躯体形式障碍患者的情绪识别受损，并表明躯体形式障碍患者的共情缺陷存在特定模式，即“共情痛苦”存在明显困难。此外，躯体形式障碍患者在“所有情绪”-“对照”、“愤怒”-“对照”和“喜悦”-“对照”的对比中显示出大脑活动减少的区域，而在“厌恶”-“对照”和“中性”-“对照”的对比中未发现大脑活动改变的区域。躯体形式障碍患者活动减少的显著簇包括双侧海马旁回、左侧杏仁核、左侧中央后回、左侧颞上回、左侧后岛叶和双侧小脑。这些发现表明，躯体形式障碍患者的情绪共情受损与情绪识别受损以及负责情绪评估、情绪记忆和情绪产生的大脑区域的异常活动有关。
