Cerebral Cortex Advance Access published online on December 5, 2006
Cerebral Cortex, doi:10.1093/cercor/bhl130
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Empathy and Judging Other's Pain: An fMRI Study of Alexithymia
1 Department of Psychosomatic Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira City, Tokyo 187-8553, Japan, 2 Department of Radiology, National Center Hospital for Mental, Nervous, and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira City, Tokyo 187-8553, Japan, 3 Department of Nuclear Medicine, Saitama Medical School Hospital, Iruma-gun, Saitama 350-0495, Japan, 4 Department of Psychology, The University of Chicago, Chicago, IL 60637, USA, 5 Graduate School of Art and Design, Joshibi University of Art and Design, Sagamihara, Kanagawa 228-8538, Japan
Address correspondence to Yoshiya Moriguchi, Department of Psychosomatic Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi Cho, Kodaira City, Tokyo 187-8551, Japan. Email: ymorigu{at}ncnp.go.jp.
Because awareness of emotional states in the self is a prerequisite to recognizing such states in others, alexithymia (ALEX), difficulty in identifying and expressing one's own emotional states, should involve impairment in empathy. Using functional magnetic resonance imaging (fMRI), we compared an ALEX group (n = 16) and a non-alexithymia (non-ALEX) group (n = 14) for their regional hemodynamic responses to the visual perception of pictures depicting human hands and feet in painful situations. Subjective pain ratings of the pictures and empathy-related psychological scores were also compared between the 2 groups. The ALEX group showed less cerebral activation in the left dorsolateral prefrontal cortex (DLPFC), the dorsal pons, the cerebellum, and the left caudal anterior cingulate cortex (ACC) within the pain matrix. The ALEX group showed greater activation in the right insula and inferior frontal gyrus. Furthermore, alexithymic participants scored lower on the pain ratings and on the scores related to mature empathy. In conclusion, the hypofunction in the DLPFC, brain stem, cerebellum, and ACC and the lower pain-rating and empathy-related scores in ALEX are related to cognitive impairments, particularly executive and regulatory aspects, of emotional processing and support the importance of self-awareness in empathy.
Key Words: anterior cingulate cortex • dorsolateral prefrontal cortex • emotion regulation • empathy • self-awareness
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