Inter-individual differences in successful perspective taking during pain perception mediates emotional responsiveness in self and others: an fMRI study.

Human empathy is an important component of social cognition that involves complex processes of emotional perspective taking and the issue of self/other distinction. Empathic perception enables us to experience negative emotions when someone else undergoes painful events. We investigated the influence of an extended time interval (10s) and subjective performance evaluation (following each trial) of perspective taking on the cortical and subcortical correlates of pain empathy in eighteen healthy subjects using functional magnetic resonance imaging (fMRI). Subjects were presented pictures of hands and feet in painful and non-painful situations. They were instructed to simply view the picture (View) or adopt either their own perspective (Self) or the perspective of a third-person (Other). Prolonged time intervals of stimulus presentation enabled the analysis of different perspective taking processes (Self versus Other). Enhanced activation in the left supramarginal gyrus was detected for adopting the Self compared to the Other perspective. Time course analysis showed an early peak in the trials, suggesting that taking the first-person perspective is an intuitive more automatic process. The comparison between the Other and Self condition evoked stronger activity in dorso- and ventrolateral prefrontal areas and the superior temporal sulcus (STS). For these areas, a peak in the later phase of the trials was found, suggesting that taking the third-person perspective requires more effort and is an ongoing process. This was also supported by the fact that the participants were subjectively more successful in adopting the Self perspective compared to the Other. Our findings support that especially during the Other condition, prolonged time periods seem to facilitate empathic responses. Individual ratings of performance enabled the comparison between subjects that were successful and unsuccessful at taking the Self or Other perspective. For Self, differential activations were found in the left insula and postcentral gyrus. For Other, differential activations were mainly observed in the left pallidum, bilateral VLPFC, the right middle orbitofrontal cortex OFC and the middle cingulate cortex (MCC). These results suggest that trial-specific success ratings allow us to disentangle differences between effort-related and successful engagement in perspective taking. These two adjustments to the well-known paradigm showed new insight into the aspects of perspective taking during pain perception.