Inability to empathize: brain lesions that disrupt sharing and understanding another's emotions

Empathy in Adults with Acquired Brain Injury: a Systematic Review and Meta-Analysis

Empathy is the ability to recognise, share and understand others' emotional states. Increasing evidence suggests that empathy may be impacted by acquired brain injury (ABI), with consequences for social and emotional functioning. However, the literature has been characterised by inconsistent findings and small sample sizes. To address these limitations, we provide the first meta-analytic review of empathy in adults with ABI. Specifically, the review aimed to quantify the degree of impairment in adults with ABI across four empathy-related domains: cognitive, affective, empathic concern (e.g. sympathy) and personal distress. We also sought to estimate the prevalence of deficits in each area and explore whether demographic and injury factors moderate impairment. A systematic search yielded 29 studies measuring self-reported empathy in adults with ABI versus healthy, matched peers. A series of random-effects meta-analyses revealed moderate deficits in cognitive empathy (Hedges' g =  - 0.68, 95% CI [- 0.87, - 0.50]) and affective empathy (Hedges' g =  - 0.43, 95% CI [- 0.65, - 0.21]), as well as small-to-moderate deficits in empathic concern (Hedges' g =  - 0.38, 95% CI [- 0.63, - 0.13]). No significant difference was found for personal distress. We estimated the proportion of ABI participants scoring equal to or more than 1 SD below the normative mean to be 15.3-35.0%, depending on the empathy subcomponent. Our results highlight that empathy deficits may play an important role in functional or emotional difficulties post-brain injury. This demonstrates the need for routine clinical assessment of empathy in survivors of brain injury and the need to develop interventions which target both cognitive and affective components.

The power of pain: The temporal-spatial dynamics of empathy induced by body gestures and facial expressions

Two non-verbal pain representations, body gestures and facial expressions, can communicate pain to others and elicit our own empathic responses. However, the specific impact of these representations on neural responses of empathy, particularly in terms of temporal and spatial neural mechanisms, remains unclear. To address this issue, the present study developed a kinetic pain empathy paradigm comprising short animated videos depicting a protagonist's "real life" pain and no-pain experiences through body gestures and facial expressions. Electroencephalographic (EEG) recordings were conducted on 52 neurotypical adults; while they viewed the animations. Results from multivariate pattern, event-related potential, event-related spectrum perturbation, and source localization analyses revealed that pain expressed through facial expressions, but not body gestures, elicited increased N200 and P200 responses and activated various brain regions, i.e., the anterior cingulate cortex, insula, thalamus, ventromedial prefrontal cortex, temporal gyrus, cerebellum, and right supramarginal gyrus. Enhanced theta power with distinct spatial distributions were observed during early affective arousal and late cognitive reappraisal stages of the pain event. Multiple regression analyses showed a negative correlation between the N200 amplitude and pain catastrophizing, and a positive correlation between the P200 amplitude and autism traits. These findings demonstrate the temporal evolution of empathy evoked by dynamic pain display, highlighting the significant impact of facial expression and its association with individuals' unique psychological traits.

Early environmental influences on the orbito-frontal cortex function and its effects on behavior

Early-life adversity during pre- and early post-natal phases can impact brain development and lead to maladaptive changes in executive function related behaviors. This increases the risk for a range of psychopathologies and physical diseases. Importantly, exposure to adversities during these periods is also linked to alterations in the orbito-frontal cortex (OFC) which is a key player in these executive functions. The OFC thus appears to be a central node in this association between early life stress and disease risk. Gaining a clear, and detailed understanding of the association between early life stress, OFC function, and executive function, as well as the underlying mechanisms mediating this association is relevant to inform potential therapeutic interventions. In this paper, we begin by reviewing evidence linking early life adversities to 1) alterations in behaviors regulated by the OFC and 2) changes in OFC anatomy and function. We then present insights into the underlying mechanisms for these changes, stemming from early life adversity models, and highlight important future directions for this line of research.

Exploring rodent prosociality: A conceptual framework

Prosociality is a behavior characterized by actions performed for the benefit or well-being of others. Recent studies have corroborated parallels in brain activation patterns between rodents and humans during prosocial behaviors. These findings have the potential to advance our understanding of social impairments observed in neurodevelopmental disorders, brain injuries, neurological conditions, and mental health disorders. However, a consensus regarding prosocial paradigms in rodents remains scattered. This conceptual framework aims to (1) reframe prosociality as a set of complex behaviors emerging in response to environmental determinants that cannot be reduced to a single set of data; (2) highlight important methodological considerations, mediating variables, and behavioral analyses that influence prosocial behaviors; and (3) present a decision tree as a dynamic element within this conceptual framework to offer guidance to researchers. The conceptual framework and decision tree are concise and straightforward, providing a robust foundation for the ongoing utilization of current models and the creation of novel paradigms. The integration of this conceptual framework into research practices will contribute to the advancement of knowledge in the field of rodent prosociality and foster greater confidence in the validity and reproducibility of study findings.

Decreased Functional and Structural Connectivity is Associated with Core Symptom Improvement in Children with Autism Spectrum Disorder After Mini-basketball Training Program

Exercise intervention has been proven helpful to ameliorate core symptoms of Autism Spectrum Disorder (ASD). However, the underlying mechanisms are not fully understood. In this study, we carried out a 12-week mini-basketball training program (MBTP) on ASD children and examined the changes of brain functional and structural networks before and after exercise intervention. We applied individual-based method to construct functional network and structural morphological network, and investigated their alterations following MBTP as well as their associations with the change in core symptom. Structural MRI and resting-state functional MRI data were obtained from 58 ASD children aged 3-12 years (experiment group: n = 32, control group: n = 26). ASD children who received MBTP intervention showed several distinguishable alternations compared to the control without special intervention. These included decreased functional connectivity within the sensorimotor network (SM) and between SM and the salience network, decreased morphological connectivity strength in a cortical-cortical network centered on the left inferior temporal gyrus, and a subcortical-cortical network centered on the left caudate. Particularly, the aforementioned functional and structural changes induced by MBTP were associated with core symptoms of ASD. Our findings suggested that MBTP intervention could be an effective approach to improve core symptoms in ASD children, decrease connectivity in both structure and function networks, and may drive the brain change towards normal-like neuroanatomy.

Loss of empathy in stroke

Background

Loss of empathy (LoE) is common among stroke survivors, yet often undiagnosed and thus untreated. LoE is related to the loss of a caring marital relationship, higher care burden and poorer quality of life in carers. The present study will evaluate the clinical and MRI correlates of LoE in a cohort of stroke survivors. The secondary objective is to describe the 12-month course of LoE.

Methods

The current study is a prospective cohort study. We will recruit 246 subjects. Subjects and carers will receive a detailed assessment at a research clinic at 3, 9, and 15 months after stroke onset (T1/T2/T3). The Chinese version of the Interpersonal Reactivity Index (IRI), a 28-item personality assessment tool, will be completed by a carer for each subject. LoE is defined as an IRI total score of 39 or less. Patients will be examined by MRI including diffusion weighted imaging (DWI) within 1 week after the onset of stroke. A stepwise logistic regression will be performed to assess the importance of lesions in the regions of interest. To examine the predictors of LoE remission, the demographic, clinical and MRI variables of remitters and non-remitters at T2/T3 will be examined by logistic regression.

Discussion

This project will be the first longitudinal study on LoE in stroke survivors. The results will shed light on the association between prefrontal cortex and subcortical lesions and LoE risk, symptom severity and outcome. The findings will provide data to advance our understanding of the pathogenesis and clinical course of LoE in stroke as well as other neurological conditions. They are thus likely to be applicable to the large population of neurological patients at risk of LoE and should also stimulate further research in this field.

Nearsighted empathy: exploring the effect of empathy on distance perception, with eye movements as modulators

Empathy, a cornerstone of social interaction, involves shared representation, eliciting vicarious emotions. However, its influence on shared perceptual representations, particularly in foundational domains such as distance perception, remains unexplored. In this study, we introduce a novel adaptation of the empathy for pain task to investigate empathy's influence on distance perception. We also examine how two personality traits, trait empathy and alexithymia, modulate this relationship. Utilizing eye-tracking technology, we examine how attention allocation to different facial and bodily features affects empathy's impact on distance perception. Our findings indicate that empathy biases individuals to perceive targets as closer, with trait empathy reinforcing this effect and alexithymia attenuating it. Furthermore, we demonstrate that heightened attention to eyes and face correlates with perceiving targets as closer, while attention to hand shows the opposite trend. These results underscore the broader influence of empathy beyond shared emotions, revealing its capacity to alter perceptual processes. By elucidating the interplay between personality traits and visual inputs in shaping these alterations, our study offers valuable insights for future research exploring the role of shared representation in empathy across various perceptual domains.

The impact of acute violent videogame exposure on neurocognitive markers of empathic concern

Research examining the purported association between violent gaming and aggression remains controversial due to concerns related to methodology, unclear neurocognitive mechanisms, and the failure to adequately consider the role of individual differences in susceptibility. To help address these concerns, we used fMRI and an emotional empathy task to examine whether acute and cumulative violent gaming exposure were associated with abnormalities in emotional empathy as a function of trait-empathy. Emotional empathy was targeted given its involvement in regulating not only aggression, but also other important social functions such as compassion and prosocial behaviour. We hypothesized that violent gaming exposure increases the risk of aberrant social behaviour by altering the aversive value of distress cues. Contrary to expectations, neither behavioural ratings nor empathy-related brain activity varied as a function of violent gaming exposure. Notably, however, activation patterns in somatosensory and motor cortices reflected an interaction between violent gaming exposure and trait empathy. Thus, our results are inconsistent with a straightforward relationship between violent gaming exposure and reduced empathy. Furthermore, they highlight the importance of considering both individual differences in susceptibility and other aspects of cognition related to social functioning to best inform public concern regarding safe gaming practices.

Neural Mechanisms of Resting-State Networks and the Amygdala Underlying the Cognitive and Emotional Effects of Psilocybin

BACKGROUND

Serotonergic psychedelics, such as psilocybin, alter perceptual and cognitive systems that are functionally integrated with the amygdala. These changes can alter cognition and emotions that are hypothesized to contribute to their therapeutic utility. However, the neural mechanisms of cognitive and subcortical systems altered by psychedelics are not well understood.

METHODS

We used resting-state functional magnetic resonance images collected during a randomized, double-blind, placebo-controlled clinical trial of 24 healthy adults under 0.2 mg/kg psilocybin to estimate the directed (i.e., effective) changes between the amygdala and 3 large-scale resting-state networks involved in cognition. These networks are the default mode network, the salience network, and the central executive network.

RESULTS

We found a pattern of decreased top-down effective connectivity from these resting-state networks to the amygdala. Effective connectivity decreased within the default mode network and salience network but increased within the central executive network. These changes in effective connectivity were statistically associated with behavioral measures of altered cognition and emotion under the influence of psilocybin.

CONCLUSIONS

Our findings suggest that temporary amygdala signal attenuation is associated with mechanistic changes to resting-state network connectivity. These changes are significant for altered cognition and perception and suggest targets for research investigating the efficacy of psychedelic therapy for internalizing psychiatric disorders. More broadly, our study suggests the value of quantifying the brain's hierarchical organization using effective connectivity to identify important mechanisms for basic cognitive function and how they are integrated to give rise to subjective experiences.

Dark triad personality traits are associated with decreased grey matter volumes in 'social brain' structures

Introduction

Personality traits and the degree of their prominence determine various aspects of social interactions. Some of the most socially relevant traits constitute the Dark Triad - narcissism, psychopathy, and Machiavellianism - associated with antisocial behaviour, disregard for moral norms, and a tendency to manipulation. Sufficient data point at the existence of Dark Triad 'profiles' distinguished by trait prominence. Currently, neuroimaging studies have mainly concentrated on the neuroanatomy of individual dark traits, while the Dark Triad profile structure has been mostly overlooked.

Methods

We performed a clustering analysis of the Dirty Dozen Dark Triad questionnaire scores of 129 healthy subjects using the k-means method. The variance ratio criterion (VRC) was used to determine the optimal number of clusters for the current data. The two-sample t-test within the framework of voxel-based morphometry (VBM) was performed to test the hypothesised differences in grey matter volume (GMV) for the obtained groups.

Results

Clustering analysis revealed 2 groups of subjects, both with low-to-mid and mid-to-high levels of Dark Triad traits prominence. A further VBM analysis of these groups showed that a higher level of Dark Triad traits may manifest itself in decreased grey matter volumes in the areas related to emotional regulation (the dorsolateral prefrontal cortex, the cingulate cortex), as well as those included in the reward system (the ventral striatum, the orbitofrontal cortex).

Discussion

The obtained results shed light on the neurobiological basis underlying social interactions associated with the Dark Triad and its profiles.

Effectiveness of training in expressing positive emotions, reacting to change and greeting peers after childhood traumatic brain injury: a single-case experimental study

Background

Social cognitive deficits are common after traumatic brain injury (TBI). The participant in this single-case experimental design (SCED) was 7 years old when he sustained a severe TBI. After 2 years in rehabilitation, he continues to show deficits in social cognition.

Objective

To determine the effectiveness of three interventions, each aimed at improving a behavior altered by social cognition deficits. These behaviors were: (1) expression of positive emotions, (2) reacting to changes in plans, and (3) greeting classmates.

Method

An A-B-A' design was used for each behavior. In addition, each behavior was targeted with a rehabilitation program applied over 10 sessions.

Results

For the first behavior, changes between phases B-A' (NAP = 0.712) and A-A' (NAP = 0.864) indicated improvements in the child's ability to express positive emotions. In the second behavior, changes in the intensity of reactions between phases B and A' (NAP = 0.815) and A vs. A' (NAP = 0.834) indicated that the child adapted to changes in a plan and to unexpected situations in a more adaptive way. For the third behavior, changes in the number of greetings between phases A and B (NAP = 0.883) and A vs. A' (NAP = 0.844) suggested that during the third phase of the study, the participant fully acquired the habit of greeting peers and increased his interactions with others.

Conclusion

While the participant showed improvements in all three targeted behaviors, due to the complexity of the third behavior, it is recommended that in future research, the intervention targeting social interactions should be applied over a longer timeframe to ensure that improvements are more stable in the long term.

Measuring Antisocial Behaviors in Behavioral Variant Frontotemporal Dementia With a Novel Informant-Based Questionnaire

OBJECTIVE

Antisocial behaviors are common and problematic among patients with behavioral variant frontotemporal dementia (bvFTD). In the present study, the investigators aimed to validate an informant-based questionnaire developed to measure the extent and severity of antisocial behaviors among patients with dementia.

METHODS

The Social Behavior Questionnaire (SBQ) was developed to measure 26 antisocial behaviors on a scale from absent (0) to very severe (5). It was administered to 23 patients with bvFTD, 19 patients with Alzheimer's disease, and 14 patients with other frontotemporal lobar degeneration syndromes. Group-level differences in the presence and severity of antisocial behaviors were measured. Psychometric properties of the SBQ were assessed by using Cronbach's alpha, exploratory factor analysis, and comparisons with a psychopathy questionnaire. Cluster analysis was used to determine whether the SBQ identifies different subgroups of patients.

RESULTS

Antisocial behaviors identified by using the SBQ were common and severe among patients with bvFTD, with at least one such behavior endorsed for 21 of 23 (91%) patients. Antisocial behaviors were more severe among patients with bvFTD, including the subsets of patients with milder cognitive impairment and milder disease severity, than among patients in the other groups. The SBQ was internally consistent (Cronbach's α=0.81). Exploratory factor analysis supported separate factors for aggressive and nonaggressive behaviors. Among the patients with bvFTD, the factor scores for aggressive behavior on the SBQ were correlated with those for antisocial behavior measured on the psychopathy scale, but the nonaggressive scores were not correlated with psychopathy scale measures. The k-means clustering analysis identified a subset of patients with severe antisocial behaviors.

CONCLUSIONS

The SBQ is a useful tool to identify, characterize, and measure the severity of antisocial behaviors among patients with dementia.

Altered functional connectivity of the amygdala across variants of callous-unemotional traits: A resting-state fMRI study in children and adolescents

Over the past years, research has shown that primary (high callousness and low anxiety) and secondary (high callousness and anxiety) variants of CU traits may be associated with opposite amygdala activity (hypo- and hyper-reactivity, respectively). However, their differences in amygdala functional connectivity remains largely unexplored. We conducted a Latent Profile Analysis on a large sample of adolescents (n = 1416) to identify homogeneous subgroups with different levels of callousness and anxiety. We then performed a seed-to-voxel connectivity analysis on resting-state fMRI data to compare subgroups on connectivity patterns of the amygdala. We examined the results in relation to conduct problems to identify potential neural risk factors. The Latent Profile Analysis revealed four subgroups, including the primary and secondary variants, anxious, and typically developing adolescents. The seed-to-voxel analyses showed that the primary variant was mainly characterized by increased connectivity between the left amygdala and left thalamus. The secondary variant exhibited deficient connectivity between the amygdala and the dorsomedial prefrontal cortex, temporo-parietal junction, premotor, and postcentral gyrus. Both variants showed increased connectivity between the left amygdala and the right thalamus but exhibited opposite functional connectivity between the left amygdala and the parahippocampal gyrus. Dimensional analyses indicated that conduct problems may play a mediating role between callousness and amygdala-dmPFC functional connectivity across youths with already high levels of callousness. Our study highlights that both variants differ in the functional connectivity of the amygdala. Our results support the importance of disentangling the heterogeneity of adolescents at risk for conduct problems in neuroimaging.

Multisite ALLFTD study modeling progressive empathy loss from the earliest stages of behavioral variant frontotemporal dementia

INTRODUCTION

Empathy relies on fronto-cingular and temporal networks that are selectively vulnerable in behavioral variant frontotemporal dementia (bvFTD). This study modeled when in the disease process empathy changes begin, and how they progress.

METHODS

Four hundred thirty-one individuals with asymptomatic genetic FTD (n = 114), genetic and sporadic bvFTD (n = 317), and 163 asymptomatic non-carrier controls were enrolled. In sub-samples, we investigated empathy measured by the informant-based Interpersonal Reactivity Index (IRI) at each disease stage and over time (n = 91), and its correspondence to underlying atrophy (n = 51).

RESULTS

Empathic concern (estimate = 4.38, 95% confidence interval [CI] = 2.79, 5.97; p < 0.001) and perspective taking (estimate = 5.64, 95% CI = 3.81, 7.48; p < 0.001) scores declined between the asymptomatic and very mild symptomatic stages regardless of pathogenic variant status. More rapid loss of empathy corresponded with subcortical atrophy.

DISCUSSION

Loss of empathy is an early and progressive symptom of bvFTD that is measurable by IRI informant ratings and can be used to monitor behavior in neuropsychiatry practice and treatment trials.

Association of inferior division MCA stroke location with populations with atrial fibrillation incidence

BACKGROUND AND AIM

Considering the anatomical features of Middle Cerebral Artery (MCA) bifurcation, larger emboli are more likely to enter the inferior division over the superior division. Since emboli of cardiac origin are larger on average than emboli of arterial origin, we hypothesize that the infarcts in temporal and parietal lobes are more likely associated to atrial fibrillation than those in the frontal lobes, therefore occurring more often in populations with higher incidence of atrial fibrillation, such as male (compared to women) and white (compared to black) patients.

METHODS

We included 197 patients with MCA "temporoparietal predominant" infarcts and 105 with "frontal predominant" infarcts. Variations between stroke location (frontal or temporoparietal), sex, and race were examined via Chi-square test.

RESULTS

Male patients were more likely than female patients to be afflicted by temporoparietal strokes versus frontal strokes, while white patients had greater likelihood than black patients to be afflicted by temporoparietal strokes versus frontal strokes. Patients with confirmed diagnosis of atrial fibrillation display more temporoparietal strokes compared to frontal strokes.

CONCLUSION

Temporoparietal MCA ischemic strokes occur more frequently in male and white patients: populations with known increased incidence of atrial fibrillation. In addition, population-specific anatomical characteristics of the MCA bifurcation might favor the larger cardiac emboli to enter the inferior division and cause temporoparietal infarcts. This association can help guide search for the most likely etiology of infarcts.

Social Cognition in Temporal and Frontal Lobe Epilepsy: Systematic Review, Meta-analysis, and Clinical Recommendations

OBJECTIVE

Despite the importance of social cognitive functions to mental health and social adjustment, examination of these functions is absent in routine assessment of epilepsy patients. Thus, this review aims to provide a comprehensive overview of the literature on four major aspects of social cognition among temporal and frontal lobe epilepsy, which is a critical step toward designing new interventions.

METHOD

Papers from 1990 to 2021 were reviewed and examined for inclusion in this study. After the deduplication process, a systematic review and meta-analysis of 44 and 40 articles, respectively, involving 113 people with frontal lobe epilepsy and 1482 people with temporal lobe epilepsy were conducted.

RESULTS

Our results indicated that while patients with frontal or temporal lobe epilepsy have difficulties in all aspects of social cognition relative to nonclinical controls, the effect sizes were larger for theory of mind (g = .95), than for emotion recognition (g = .69) among temporal lobe epilepsy group. The frontal lobe epilepsy group exhibited significantly greater impairment in emotion recognition compared to temporal lobe. Additionally, people with right temporal lobe epilepsy (g =  1.10) performed more poorly than those with a left-sided (g = .90) seizure focus, specifically in the theory of mind domain.

CONCLUSIONS

These data point to a potentially important difference in the severity of deficits within the emotion recognition and theory of mind abilities depending on the laterlization of seizure side. We also suggest a guide for the assessment of impairments in social cognition that can be integrated into multidisciplinary clinical evaluation for people with epilepsy.

[Emotional disorders after stroke]

Emotional disorders are common among patients after stroke. They include anger, fear, emotional expression control (uncontrollable crying, laughing), emotional indifference (apathy), disorders of emotion recognition and emotional empathy. They might develop independently or as a presentation of depression, anxiety, catastrophic reaction, posttraumatic stress disorder etc. Treatment of post-stroke emotional disorders include pharmacotherapy, psychotherapy, neuromodulation.

Increasing empathic concern relates to salience network hyperconnectivity in cognitively healthy older adults with elevated amyloid-β burden

Enhanced emotional empathy, the ability to share others' affective experiences, can be a feature of Alzheimer's disease (AD), but whether emotional empathy increases in the preclinical phase of the disease is unknown. We measured emotional empathy over time (range = 0 - 7.3 years, mean = 2.4 years) in 86 older adults during a period in which they were cognitively healthy, functionally normal, and free of dementia symptoms. For each participant, we computed longitudinal trajectories for empathic concern (i.e., an other-oriented form of emotional empathy that promotes prosocial actions) and emotional contagion (i.e., a self-focused form of emotional empathy often accompanied by feelings of distress) from informant ratings of participants' empathy on the Interpersonal Reactivity Index. Amyloid-β (Aβ) positron emission tomography (PET) scans were used to classify participants as either Aβ positive (Aβ+, n = 23) or negative (Aβ-, n = 63) based on Aβ-PET cortical binding. Participants also underwent structural and task-free functional magnetic resonance imaging approximately two years on average after their last empathy assessment, at which time most participants remained cognitively healthy. Results indicated that empathic concern, but not emotional contagion, increased more over time in Aβ+ participants than in Aβ- participants despite no initial group difference at the first measurement. Higher connectivity between certain salience network node-pairs (i.e., pregenual anterior cingulate cortex and periaqueductal gray) predicted longitudinal increases in empathic concern in the Aβ+ group but not in the Aβ- group. The Aβ+ participants also had higher overall salience network connectivity than Aβ- participants despite no differences in gray matter volume. These results suggest gains in empathic concern may be a very early feature of AD pathophysiology that relates to hyperconnectivity in the salience network, a system that supports emotion generation and interoception. A better understanding of emotional empathy trajectories in the early stages of AD pathophysiology will broaden the lens on preclinical AD changes and help clinicians to identify older adults who should be screened for AD biomarkers.

Predicting youth aggression with empathy and callous unemotional traits: A Meta-analytic review

Historically, empathy has been thought to motivate prosocial behaviour and inhibit aggressive behaviour. Contrary to current assumptions and theoretical support, a meta-analysis revealed a small effect of empathy on aggression among adults (Vachon, Lynam, & Johnson, 2014). The current study sought to determine whether broadening the focus from empathy to include other socially relevant affective characteristics (i.e., callous-unemotional traits) was advantageous in predicting aggressive behaviour. As little is known about the strength of this association among youth, the current study meta-analytically examined 192 unique effect sizes drawn from published and unpublished studies reporting on samples of children and adolescents. Analyses were conducted across general, cognitive, and emotional empathy, as well as callous-unemotional traits, and general, direct, indirect, proactive, and reactive aggression. Significant variability was noted across effect sizes. Consistent with a prior meta-analysis involving adults (Vachon et al., 2014), small to moderate associations were identified between aggression and traditional measures of empathy (i.e., general, emotional, cognitive); these effects ranged from r = -0.06 to -0.26. Among broader measures of emotional style (i.e., callous-unemotional traits), moderate to large effects were found; ranging from r = 0.30 to 0.37. Results suggested that broader affective measures may be more strongly associated with aggression than empathy alone. The results raise questions about the nature of empathy assessment and indicate the utility of targeting multiple emotion-related factors during treatment to effectively reduce aggressive behaviour. In particular, the results underscore of the importance of considering the limited prosocial emotions specifier (perhaps trans-diagnostically given the varied nature of the sample) when considering implications for prognosis and treatment targets.

From bench to bedside: The mGluR5 system in people with and without Autism Spectrum Disorder and animal model systems

The metabotropic glutamate receptor 5 (mGluR5) is a key regulator of excitatory (E) glutamate and inhibitory (I) γ-amino butyric acid (GABA) signalling in the brain. Despite the close functional ties between mGluR5 and E/I signalling, no-one has directly examined the relationship between mGluR5 and glutamate or GABA in vivo in the human brain of autistic individuals. We measured [¹⁸F] FPEB (¹⁸F-3-fluoro-5-[(pyridin-3-yl)ethynyl]benzonitrile) binding in 15 adults (6 with Autism Spectrum Disorder) using two regions of interest, the left dorsomedial prefrontal cortex and a region primarily composed of left striatum and thalamus. These two regions were mapped out using MEGA-PRESS voxels and then superimposed on reconstructed PET images. This allowed for direct comparison between mGluR5, GABA + and Glx. To better understand the molecular underpinnings of our results we used an autoradiography study of mGluR5 in three mouse models associated with ASD: Cntnap2 knockout, Shank3 knockout, and 16p11.2 deletion. Autistic individuals had significantly higher [¹⁸F] FPEB binding (t (13) = -2.86, p = 0.047) in the left striatum/thalamus region of interest as compared to controls. Within this region, there was a strong negative correlation between GABA + and mGluR5 density across the entire cohort (Pearson's correlation: r (14) = -0.763, p = 0.002). Cntnap2 KO mice had significantly higher mGlu5 receptor binding in the striatum (caudate-putamen) as compared to wild-type (WT) mice (n = 15, p = 0.03). There were no differences in mGluR5 binding for mice with the Shank3 knockout or 16p11.2 deletion. Given that Cntnap2 is associated with a specific striatal deficit of parvalbumin positive GABA interneurons and 'autistic' features, our findings suggest that an increase in mGluR5 in ASD may relate to GABAergic interneuron abnormalities.

Effects of emotional valence and intensity on cognitive and affective empathy after insula lesions

The insula plays a central role in empathy. However, the complex structure of cognitive (CE) and affective empathy (AE) deficits following insular damage is not fully understood. In the present study, patients with insular lesions (n = 20) and demographically matched healthy controls (n = 24) viewed ecologically valid videos that varied in terms of valence and emotional intensity. The videos showed a person (target) narrating a personal life event. In CE conditions, subjects continuously rated the affective state of the target, while in AE conditions, they continuously rated their own affect. Mean squared error (MSE) assessed deviations between subject and target ratings. Patients differed from controls only in negative, low-intensity AE, rating their own affective state less negative than the target. This deficit was not related to trait empathy, neuropsychological or clinical parameters, or laterality of lesion. Empathic functions may be widely spared after insular damage in a naturalistic, dynamic setting, potentially due to the intact interpretation of social context by residual networks outside the lesion. The particular role of the insula in AE for negative states may evolve specifically in situations that bear higher uncertainty pointing to a threshold role of the insula in online ratings of AE.

Social problem solving and trait socioemotional abilities in ambulatory stroke patients

INTRODUCTION

Stroke has been associated with sociocognitive impairment, so far well documented for emotion recognition and Theory of Mind. However, more complex abilities, such as social problem solving, which directly facilitate appropriate behavior in social situations have been neglected in previous research.

METHOD

The present study aimed to address this gap by focusing on performance-based social problem solving abilities and self-reported socioemotional abilities (i.e., empathy and alexithymia) in outpatient stroke patients (n = 36) compared to a group of healthy controls (n = 36) equivalent on age, gender, and education. In further analyses, potential lateralization effects and correlations between social problem solving/socioemotional functioning and demographic and clinical data were investigated.

RESULTS

In the main analyses, patients were impaired in their ability to freely generate appropriate solutions for challenging interpersonal situations depicted in written scenarios but performed on a comparable level as healthy controls when they had to choose the optimal solution presented amidst a range of less optimal options. While showing difficulty in identifying the awkward elements in the scenarios, the patient group nevertheless rated the degree of discomfort attributed to these elements on a level comparable to the control group. On the self-report measures, stroke patients reported overall higher degrees of alexithymia (i.e., an inability to describe and identify one's own and other persons´ emotions) and more personal distress in response to other individuals´ emotional suffering as assessed by self-report.

CONCLUSIONS

The present results suggest that stroke is associated with a broad impact on socioemotional and social problem solving abilities. As difficulties in social problem solving might be associated with increased psychosocial burden they ought to be addressed in stroke rehabilitation.

Left Hemisphere Bias of NIH Stroke Scale Is Most Severe for Middle Cerebral Artery Strokes

NIHSS score is higher for left vs. right hemisphere strokes of equal volumes. However, differences in each vascular territory have not been evaluated yet. We hypothesized that left vs. right differences are driven by the middle cerebral artery (MCA) territory, and there is no difference between hemispheres for other vascular territories. This study is based on data from 802 patients with evidence of acute ischemic stroke in one major arterial territory (MCA, n = 437; PCA, n = 209; ACA, n = 21; vertebrobasilar, n = 46). We examined differences in patients with left or right strokes regarding to lesion volume, NIHSS, and other covariates (age, sex, race). We used linear models to test the effects of these covariates on NIHSS. We looked at the whole sample as well as in the sample stratified by NIHSS (≤5 or >5) and by lesion location (MCA or PCA). Patients with left MCA strokes had significantly higher NIHSS than those with right strokes. Only patients with MCA strokes showed NIHSS score affected by the hemisphere when controlling for stroke volume and patient's age. This difference was driven by the more severe strokes (NIHSS>5). It is important to consider this systematic bias in the NIHSS when using the score for inclusion criteria for treatment or trials. Patients with right MCA stroke may be under-treated and left with disabling deficits that are not captured by the NIHSS.

Abnormal asymmetry correlates with abnormal enlargement in a patient with chronic moderate traumatic brain injury

Aim:

Recent studies found patients with chronic, mild or moderate traumatic brain injury had more regions of enlargement than atrophy. There is little research discussing brain volume enlargement, asymmetry and TBI.

Materials & methods:

In this report, we describe a 40-year-old man who suffered a left cerebral hemorrhage resulting in a moderate TBI, suggesting greater forces on the left side of his brain. NeuroQuant^® brain volumetric analyses of his MRI obtained 1.7 years post injury showed left cerebral white matter atrophy but right gray matter abnormal enlargement. Abnormal asymmetry of multiple regions (R >L) was confirmed by NeuroGage^® asymmetry analyses.

Discussion:

The findings suggested that abnormal brain volume enlargement was due to hyperactivity and hypertrophy of less-injured brain regions as a compensatory response to more-injured regions.

Differentiating distinct and converging neural correlates of types of systemic environmental exposures

Systemic environmental disadvantage relates to a host of health and functional outcomes. Specific structural factors have seldom been linked to neural structure, however, clouding understanding of putative mechanisms. Examining relations during childhood/preadolescence, a dynamic period of neurodevelopment, could aid bridge this gap. A total of 10,213 youth were recruited from the Adolescent Brain and Cognitive Development study. Self-report and objective measures (Census and Federal bureau of investigation metrics extracted using geocoding) of environmental exposures were used, including stimulation indexing lack of safety and high attentional demands, discrepancy indexing social exclusion/lack of belonging, and deprivation indexing lack of environmental enrichment. Environmental measures were related to cortical thickness, surface area, and subcortical volume regions, controlling for other environmental exposures and accounting for other brain regions. Self-report (|β| = .04-.09) and objective (|β| = .02-.06) environmental domains related to area/thickness in overlapping (e.g., insula, caudal anterior cingulate), and unique regions (e.g., for discrepancy, rostral anterior and isthmus cingulate, implicated in socioemotional functions; for stimulation, precuneus, critical for cue reactivity and integration of environmental cues; and for deprivation, superior frontal, integral to executive functioning). For stimulation and discrepancy exposures, self-report and objective measures showed similarities in correlate regions, while deprivation exposures evidenced distinct correlates for self-report and objective measures. Results represent a necessary step toward broader work aimed at establishing mechanisms and correlates of structural disadvantage, highlighting the relevance of going beyond aggregate models by considering types of environmental factors, and the need to incorporate both subjective and objective measurements in these efforts.

Intrinsic Shapes of Empathy: Functional Brain Network Topology Encodes Intersubjective Experience and Awareness Traits

Trait empathy is an essential personality feature in the intricacy of typical social inclinations of individuals. Empathy is likely supported by multilevel neuronal network functioning, whereas local topological properties determine network integrity. In the present functional MRI study (N = 116), we aimed to trace empathic traits to the intrinsic brain network architecture. Empathy was conceived as composed of two dimensions within the concept of pre-reflective, intersubjective understanding. Vicarious experience consists of the tendency to resonate with the feelings of other individuals, whereas intuitive understanding refers to a natural awareness of others’ emotional states. Analyses of graph theoretical measures of centrality showed a relationship between the fronto-parietal network and psychometric measures of vicarious experience, whereas intuitive understanding was associated with sensorimotor and subcortical networks. Salience network regions could constitute hubs for information processing underlying both dimensions. The network properties related to empathy dimensions mainly concern inter-network information flow. Moreover, interaction effects implied several sex differences in the relationship between functional network organization and trait empathy. These results reveal that distinct intrinsic topological network features explain individual differences in separate dimensions of intersubjective understanding. The findings could help understand the impact of brain damage or stimulation through alterations of empathy-related network integrity.

Asymmetric affective perspective taking effects toward valence influenced by personality perspective taken

Previously, we found that taking perspectives of two polar targets of the neuroticism dimension of personality influenced affect evaluations of negative pictures more than positive pictures. As neuroticism is more reactive to negative affects, the current follow-up experiment explores the effect of affective perspective taking (APT) when perspectives are derived from extroversion, which is more reactive to positive affects. Stimuli consisted of neutral, sad, and happy pictures, which were rated from the perspectives of an introvert and an extrovert. Emotional strength rating was a dependent variable, and N = 41. We found a significant interaction between APT and valence. The difference in ratings between adopting an introverted and an extroverted perspective toward happiness was larger than toward sadness. Together with the results from our previous study, these results suggest an asymmetric influence of APT toward positive and negative valances and that the direction of influence asymmetry depends on the type of personality dimension from which perspectives are derived.

Investigating the contribution of white matter hyperintensities and cortical thickness to empathy in neurodegenerative and cerebrovascular diseases

Change in empathy is an increasingly recognised symptom of neurodegenerative diseases and contributes to caregiver burden and patient distress. Empathy impairment has been associated with brain atrophy but its relationship to white matter hyperintensities (WMH) is unknown. We aimed to investigate the relationships amongst WMH, brain atrophy, and empathy deficits in neurodegenerative and cerebrovascular diseases. Five hundred thirteen participants with Alzheimer's disease/mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia (FTD), Parkinson's disease, or cerebrovascular disease (CVD) were included. Empathy was assessed using the Interpersonal Reactivity Index. WMH were measured using a semi-automatic segmentation and FreeSurfer was used to measure cortical thickness. A heterogeneous pattern of cortical thinning was found between groups, with FTD showing thinning in frontotemporal regions and CVD in left superior parietal, left insula, and left postcentral. Results from both univariate and multivariate analyses revealed that several variables were associated with empathy, particularly cortical thickness in the fronto-insulo-temporal and cingulate regions, sex (female), global cognition, and right parietal and occipital WMH. Our results suggest that cortical atrophy and WMH may be associated with empathy deficits in neurodegenerative and cerebrovascular diseases. Future work should consider investigating the longitudinal effects of WMH and atrophy on empathy deficits in neurodegenerative and cerebrovascular diseases.

Using causal methods to map symptoms to brain circuits in neurodevelopment disorders: moving from identifying correlates to developing treatments

A wide variety of model systems and experimental techniques can provide insight into the structure and function of the human brain in typical development and in neurodevelopmental disorders. Unfortunately, this work, whether based on manipulation of animal models or observational and correlational methods in humans, has a high attrition rate in translating scientific discovery into practicable treatments and therapies for neurodevelopmental disorders.With new computational and neuromodulatory approaches to interrogating brain networks, opportunities exist for "bedside-to bedside-translation" with a potentially shorter path to therapeutic options. Specifically, methods like lesion network mapping can identify brain networks involved in the generation of complex symptomatology, both from acute onset lesion-related symptoms and from focal developmental anomalies. Traditional neuroimaging can examine the generalizability of these findings to idiopathic populations, while non-invasive neuromodulation techniques such as transcranial magnetic stimulation provide the ability to do targeted activation or inhibition of these specific brain regions and networks. In parallel, real-time functional MRI neurofeedback also allow for endogenous neuromodulation of specific targets that may be out of reach for transcranial exogenous methods.Discovery of novel neuroanatomical circuits for transdiagnostic symptoms and neuroimaging-based endophenotypes may now be feasible for neurodevelopmental disorders using data from cohorts with focal brain anomalies. These novel circuits, after validation in large-scale highly characterized research cohorts and tested prospectively using noninvasive neuromodulation and neurofeedback techniques, may represent a new pathway for symptom-based targeted therapy.

The influence of role awareness, empathy induction and trait empathy on dictator game giving

We ask how state empathy, trait empathy, and role awareness influence dictator game giving in a monetarily incentivized experiment. We manipulated two factors: role awareness (role certainty vs. role uncertainty) and state empathy induction (no empathy induction vs. empathy induction). Under role uncertainty, participants did not know their role as a dictator or a recipient when making their choices. State empathy was induced by asking the dictators to consider what the recipient would feel when learning about the decision. Each participant was randomly assigned into one of the four conditions, and in each condition, participants were randomly assigned into dictator and receiver roles. The role assignment took place before or after decisions were made, depending on the condition. We also studied the direct influence of trait empathy on dictator game giving as well as its interaction with the experimental manipulations. Trait empathy was measured by the Interpersonal Reactivity Index (IRI) and the Questionnaire of Cognitive and Affective Empathy (QCAE) before the experiment. Of our experimental manipulations, role awareness had an effect on dictator game giving; participants donated more under role uncertainty than under role certainty. Instead, we did not observe an effect of state empathy induction. Of trait empathy subscales, only affective empathy was positively associated with dictator game giving. Finally, role awareness did not influence all participants similarly but had a larger impact on those with low scores on trait empathic concern or trait affective empathy. Our results indicate that specific measures to induce altruistic sharing can be effective but their effect may vary depending on certain personal characteristics.

Mind-wandering: mechanistic insights from lesion, tDCS, and iEEG

Cognitive neuroscience has witnessed a surge of interest in investigating the neural correlates of the mind when it drifts away from an ongoing task and the external environment. To that end, functional neuroimaging research has consistently implicated the default mode network (DMN) and frontoparietal control network (FPCN) in mind-wandering. Yet, it remains unknown which subregions within these networks are necessary and how they facilitate mind-wandering. In this review, we synthesize evidence from lesion, transcranial direct current stimulation (tDCS), and intracranial electroencephalogram (iEEG) studies demonstrating the causal relevance of brain regions, and providing insights into the neuronal mechanism underlying mind-wandering. We propose that the integration of complementary approaches is the optimal strategy to establish a comprehensive understanding of the neural basis of mind-wandering.

Self-Conscious Emotions and the Right Fronto-Temporal and Right Temporal Parietal Junction

For more than two decades, research focusing on both clinical and non-clinical populations has suggested a key role for specific regions in the regulation of self-conscious emotions. It is speculated that both the expression and the interpretation of self-conscious emotions are critical in humans for action planning and response, communication, learning, parenting, and most social encounters. Empathy, Guilt, Jealousy, Shame, and Pride are all categorized as self-conscious emotions, all of which are crucial components to one’s sense of self. There has been an abundance of evidence pointing to the right Fronto-Temporal involvement in the integration of cognitive processes underlying the expression of these emotions. Numerous regions within the right hemisphere have been identified including the right temporal parietal junction (rTPJ), the orbitofrontal cortex (OFC), and the inferior parietal lobule (IPL). In this review, we aim to investigate patient cases, in addition to clinical and non-clinical studies. We also aim to highlight these specific brain regions pivotal to the right hemispheric dominance observed in the neural correlates of such self-conscious emotions and provide the potential role that self-conscious emotions play in evolution.

Contagious Depression: Automatic Mimicry and the Mirror Neuron System - A Review

Contagious depression is a theory proposing that depression can be induced or triggered by our social environment. This theory is based on emotional contagion, the idea that affective states can be transferred during social interaction, since humans can use emotional contagion to communicate feelings and emotions in conscious and unconscious ways. This review presents behavioral, physiological, and neuroanatomical aspects of two essential contagious depression mechanisms, automatic mimicry and the mirror neuron system.

Amygdala network reorganization mediates the theory of mind performances in multiple sclerosis

Theory of mind (ToM) seems to be affected in multiple sclerosis (MS). MRI studies suggested a role of the amygdala in social cognitive performances. Therefore, we explored the role of the amygdala network in ToM using a multimodal MRI approach. In MS, patients with impaired ToM showed contradictory dysexecutive neuropsychological profile. Therefore, we compared neural networks involved in ToM and executive functions (EFs). Twenty patients with relapsing-remitting MS and 15 matched healthy controls were selected. ToM (Faux Pas test and mind stories) and EFs were assessed within and outside the scanner. All subjects underwent a battery of neuropsychological tests. Multimodal MRI with structural (diffusion imaging) and functional (resting-state and task-based) sequences was used to analyze the role and connections of the amygdala in ToM functioning. Cognitive and ToM performances were similar between patients and controls. Resting-state data revealed decreased connectivity of the left amygdala with frontal areas in patients compared to controls (p < 0.0001). During the task-based functional MRI, patients demonstrated increased connectivity between the amygdala and several cerebellar and left temporal regions (all p < 0.05). The microstructural alterations between the left amygdala and left temporal regions were associated with increased functional connectivity within the same pathway (r = 0.74; p < 0.01). No overlap was observed between functional networks involved in ToM and EFs. Our study demonstrates more connectivity recruitment between the amygdala and cerebellar and temporal regions in MS patients to reach preserved ToM performance. Microstructural abnormalities have been related to this compensatory network. Finally, different networks were involved in EFs and ToM.

Psychiatric sequelae of stroke affecting the non-dominant cerebral hemisphere

There are a plethora of cognitive sequelae in addition to neglect and extinction that arise with unilateral right hemispheric stroke (RHS). Cognitive deficits following non-dominant (right) hemisphere stroke are common with unilateral neglect and extinction being the most recognized examples. The severity of RHS is usually underestimated by the National Institutes of Health Stroke Scale (NIHSS), which in terms of lateralized right hemisphere cognitive deficits, tests only for visual inattention/extinction. They account for 2 out of 42 total possible points. Additional neuropsychiatric sequelae include but are not limited to deficiencies in affective prosody comprehension and production (aprosodias), understanding and expressing facial emotions, empathy, recognition of familiar faces, anxiety, mania, apathy, and psychosis. These sequelae have a profound impact on patients' quality of life; affecting communication, interpersonal relationships, and the ability to fulfill social roles. They also pose additional challenges to recovery. There is presently a gap in the literature regarding a cohesive overview of the significant cognitive sequelae following RHS. This paper serves as a narrative survey of the current understanding of the subject, with particular emphasis on neuropsychiatric poststroke syndromes not predominantly associated with left hemisphere lesions (LHL), bilateral lesions, hemiplegia, or paralysis. A more comprehensive understanding of the neuropsychological consequences of RHS extending beyond the typical associations of unilateral neglect and extinction may have important implications for clinical practice, including the ways in which clinicians approach diagnostics, treatment, and rehabilitation.

Individualized Prediction of Females' Empathic Concern from Intrinsic Brain Activity within General Network of State Empathy

Empathy can be measured based on behavioral tasks and self-report scales, which have been used to characterize the state and trait empathy, respectively, in previous studies. The neural correlates of state empathy have been deeply investigated, whereas the association between trait empathy and brain activity remains unclear. Thus, this study employed multiple variate pattern analysis (MVPA) to explore whether intrinsic brain activity (IBA) within state-empathy-related regions was associated with trait empathy. Meta-analysis of empathy-related fMRI experiments identified a general network underlying state empathy, which is located in the bilateral supplementary motor area (SMA) extending to the middle cingulate cortex (MCC) and left anterior insula (AI) and extending to the inferior frontal gyrus (IFG). The subsequent MVPA found that empathic concern can be predicted through the IBA of the general network at the female individual level (i.e., the fractional amplitude of low-frequency fluctuations and regional homogeneity). Based on the resting state fMRI (rs-fMRI), these results further support the involvement of SMA/MCC and AI/IFG in empathy. Meanwhile, the significant predictive association between IBA and trait empathy offers new insights into the general component of empathy, which may indicate the potential of using rs-fMRI to achieve the objective measurement of empathic ability.

Impaired Perception of Unintentional Transgression of Social Norms after Prefrontal Cortex Damage: Relationship to Decision Making, Emotion Recognition, and Executive Functions

OBJECTIVE

Patients with prefrontal cortex damage often transgress social rules and show lower accuracy in identifying and explaining inappropriate social behavior. The objective of this study was to examine the relationship between the ability to perceive other unintentional transgressions of social norms and both decision making and emotion recognition as these abilities are critical for appropriate social behavior.

METHOD

We examined a group of patients with focal prefrontal cortex damage (N = 28) and a group of matched control participants (N = 28) for their abilities to detect unintentional transgression of social norms using the "Faux-Pas" task of theory of mind, to make advantageous decisions on the Iowa gambling task, and to recognize basic emotions on the Ekman facial affect test.

RESULTS

The group of patients with frontal lobe damage was impaired in all of these tasks compared with control participants. Moreover, all the "Faux-Pas", Iowa gambling, and emotion recognition tasks were significantly associated and predicted by executive measures of inhibition, flexibility, or planning. However, only measures from the Iowa gambling task were associated and predicted performance on the "Faux-Pas" task. These tasks were not associated with performance in recognition of basic emotions. These findings suggest that theory of mind, executive functions, and decision-making abilities act in an interdependent way for appropriate social behavior. However, theory of mind and emotion recognition seem to have distinct but additive effects upon social behavior. Results from VLSM analysis also corroborate these data by showing a partially overlapped prefrontal circuitry underlying these cognitive domains.

Associations between oxytocin and empathy in humans: A systematic literature review

This is a systematic review about the association between empathic behavior and oxytocin (OXT). Searches were conducted in the electronic databases PubMed, Web of Science, PsycINFO, SciELO, and LILACS using the search terms "oxytocin", "empathy", and "empathic". Forty-four studies were reviewed. Scarce findings point to a lack of association between baseline endogenous OXT levels and empathy traits, and for a trend towards a direct relationship between oxytocinergic reactivity and empathic functioning. The results showed that variations in empathy were related to polymorphisms in the OXT receptor gene, especially in rs53576, and that this relationship seems to mediated by individual, ethnic, and cultural characteristics. Most studies on the exogenous administration of OXT tested a single dose (24 IU) with positive effects mainly on the affective domain of empathy. At the neural level, findings were inconsistent. Taken together, the results of the studies reviewed support the existence of a relationship between OXT and empathy that is complex and multifaceted. Robust evidence is still needed to elucidate existing links. Future investigations could benefit from methodological improvements aimed at increasing the reproducibility and applicability of findings, as well as the systematic assessment of the effects of exogenous OXT considering dose and frequency of administration, genotyping, and hormonal availability at the peripheral and central levels. This should lead to significant progress in the understanding of the therapeutic possibilities of OXT in the domain of empathic behavior.

EEG and fMRI evidence for autobiographical memory reactivation in empathy

Empathy relies on the ability to mirror and to explicitly infer others' inner states. Theoretical accounts suggest that memories play a role in empathy, but direct evidence of reactivation of autobiographical memories (AM) in empathy is yet to be shown. We addressed this question in two experiments. In Experiment 1, electrophysiological activity (EEG) was recorded from 28 participants. Participants performed an empathy task in which targets for empathy were depicted in contexts for which participants either did or did not have an AM, followed by a task that explicitly required memory retrieval of the AM and non‐AM contexts. The retrieval task was implemented to extract the neural fingerprints of AM and non‐AM contexts, which were then used to probe data from the empathy task. An EEG pattern classifier was trained and tested across tasks and showed evidence for AM reactivation when participants were preparing their judgement in the empathy task. Participants self‐reported higher empathy for people depicted in situations they had experienced themselves as compared to situations they had not experienced. A second independent fMRI experiment replicated this behavioural finding and showed increased activation for AM compared to non‐AM in the brain networks underlying empathy: precuneus, posterior parietal cortex, superior and inferior parietal lobule, and superior frontal gyrus. Together, our study reports behavioural, electrophysiological, and fMRI evidence that robustly supports AM reactivation in empathy.

Affective empathy in neurodegenerative disorders: The importance of measurement type

In recent years, there has been increasing attention focused on affective empathy in neurodegenerative disorders (NDs). However, prior studies have identified discrepancies not only between, but sometimes within, specific NDs. These discrepancies may reflect methodological differences in how affective empathy has been operationalized, with three quite distinct approaches to assessment possible (self-report, informant-report and performance-based). Therefore, we conducted the first meta-analytic review of affective empathy in people with NDs, that considered the potential moderating role of measurement type. Across 27 studies that included 1456 people with NDs and 832 controls, the results showed that most NDs are associated with impaired affective empathy, but that the magnitude of these difficulties differs meaningfully across disorders. However, most importantly, the results indicated that measurement type is a critical consideration in this literature, with substantive differences emerging for self- versus informant-rated measures. These results are discussed in relation to their practical implications for clinical assessment, as well as how they help to inform current theoretical understanding of affective empathic processing.

Variability in Brain Structure and Function Reflects Lack of Peer Support

Humans are a highly social species. Complex interactions for mutual support range from helping neighbors to building social welfare institutions. During times of distress or crisis, sharing life experiences within one's social circle is critical for well-being. By translating pattern-learning algorithms to the UK Biobank imaging-genetics cohort (n = ~40 000 participants), we have delineated manifestations of regular social support in multimodal whole-brain measurements. In structural brain variation, we identified characteristic volumetric signatures in the salience and limbic networks for high- versus low-social support individuals. In patterns derived from functional coupling, we also located interindividual differences in social support in action-perception circuits related to binding sensory cues and initiating behavioral responses. In line with our demographic profiling analysis, the uncovered neural substrates have potential implications for loneliness, substance misuse, and resilience to stress.

Extensive long-term verbal memory training is associated with brain plasticity

The human brain has a remarkable capacity to store a lifetime of information through visual or auditory routes. It excels and exceeds any artificial memory system in mixing and integrating multiple pieces of information encoded. In this study, a group of verbal memory experts was evaluated by multiple structural brain analysis methods to record the changes in the brain structure. The participants were professional Hindu pandits (priests/scholars) trained in reciting Vedas and other forms of Hindu scriptures. These professional Vedic priests are experts in memorization and recitation of oral texts with precise diction. Vedas are a collection of hymns. It is estimated that there are more than 20,000 mantras and shlokas in the four Vedas. The analysis included the measurement of the grey and white matter density, gyrification, and cortical thickness in a group of Vedic pandits and comparing these measures with a matched control group. The results revealed an increased grey matter (GM) and white matter (WM) in the midbrain, pons, thalamus, parahippocampus, and orbitofrontal regions in pandits. The whole-brain corelation analysis using length of post-training  teaching duration showed significant correlation with the left angular gyrus. We also found increased gyrification in the insula, supplementary motor area, medial frontal areas, and increased cortical thickness (CT) in the right temporal pole and caudate regions of the brain. These findings, collectively, provide unique information regarding the association between crucial memory regions in the brain and long-term practice of oral recitation of scriptures from memory with the proper diction that also involved controlled breathing.

Perspective taking effects are modulated by the valence of stimuli

Previously we found perspective taking (PT) influenced affect ratings of negative pictures more than neutral pictures. The current follow-up experiments extend that research to explore effects of perspective taking with positive valence pictures. We used stimuli consisting of neutral, happy and sad pictures. Stimuli were presented either mixed within blocks (Experiment 1) or separated by emotion (neutrals + happy/sad) into two separate blocks (Experiment 2). Participants rated (from 1- to 7 based on emotional strength) stimuli from different perspectives (sensitive/tough/their own, i.e., "me"). Emotional strength rating was a dependent variable. A significant interaction between valence and PT was found in both experiments. The difference between adopting sensitive and tough perspectives toward sadness was larger than toward the neutral condition, replicating our results from the previous study. The same difference (sensitive-tough) was larger toward the happiness condition than toward the neutral one (this was a trend in Experiment 1 and was significant in Experiment 2) and toward the sadness condition than toward the happy one. These results suggest that PT effects on emotional ratings are modulated by valence of stimuli.

Probing the role of the right inferior frontal gyrus during Pain-Related empathy processing: Evidence from fMRI and TMS

Recent studies have suggested that the right inferior frontal gyrus (rIFG) may be involved in pain-related empathy. To verify the role of the rIFG, we performed a functional magnetic resonance imaging (fMRI) experiment to replicate previous research and further designed a noninvasive repetitive transcranial magnetic stimulation (rTMS) experiment to probe the causal role of the rIFG in pain-related empathy processing. We assigned 74 volunteers (37 females) to three groups. Group 1 (n = 26) performed a task in which participants were required to perceive pain in others (task of pain: TP) and we used fMRI to observe the activity of the rIFG during pain-related empathy processing. Then, we applied online rTMS to the rIFG and the vertex site (as reference site) to observe the performance of Group 2 (n = 24; performing TP) and Group 3 (n = 24; performing a control task of identifying body parts; task of body: TB). fMRI experiment demonstrated stronger activation in the rIFG than in the vertex during the perception of pain in others (p < .0001, Bonferroni-corrected). rTMS experiment indicated that when the rIFG was temporarily disrupted, participants perceived pain in others significantly more slowly (p < .0001, Bonferroni-corrected) than when the vertex was disrupted. Our results provide evidence that the rIFG is involved in pain-related empathy processing, which yields insights into how the brain perceives pain in others.

A review of alterations to the brain during spaceflight and the potential relevance to crew in long-duration space exploration

During spaceflight, the central nervous system (CNS) is exposed to a complex array of environmental stressors. However, the effects of long-duration spaceflight on the CNS and the resulting impact to crew health and operational performance remain largely unknown. In this review, we summarize the current knowledge regarding spaceflight-associated changes to the brain as measured by magnetic resonance imaging, particularly as they relate to mission duration. Numerous studies have reported macrostructural changes to the brain after spaceflight, including alterations in brain position, tissue volumes and cerebrospinal fluid distribution and dynamics. Changes in brain tissue microstructure and connectivity were also described, involving regions related to vestibular, cerebellar, visual, motor, somatosensory and cognitive function. Several alterations were also associated with exposure to analogs of spaceflight, providing evidence that brain changes likely result from cumulative exposure to multiple independent environmental stressors. Whereas several studies noted that changes to the brain become more pronounced with increasing mission duration, it remains unclear if these changes represent compensatory phenomena or maladaptive dysregulations. Future work is needed to understand how spaceflight-associated changes to the brain affect crew health and performance, with the goal of developing comprehensive monitoring and countermeasure strategies for future long-duration space exploration.

Understanding the role of social cognition in neurodegenerative Disease: A scoping review on an overlooked problem

Social cognition (SC) is the set of socio-cognitive processes that guide automatic and voluntary behaviors by modulating behavioral responses, it includes both cognitive (Theory of the mind - ToM) and affective aspects (Empathy). SC also includes representations of internal somatic states, self-knowledge, perception of others, communication with others and interpersonal motivations. SC is relevant in daily life and reflects the neural complexity of social processing. The purpose of this scoping review is to evaluate the role of SC in neurological disorders, also considering the pathophysiological mechanisms underlying SC and potential assessment tools. The included studies were carried out between 2010 and 2019 and were found on PubMed, Scopus, Cochrane, and Web of Sciences databases, using the combined terms "social cognition"; "dementia"; "multiple sclerosis"; "parkinson", "amyotrophic lateral sclerosis", "neurodegenerative disease". Our review has shown that different SC domains are affected by several neurological conditions, with regards to dementia and amyotrophic lateral sclerosis. Further studies are needed to investigate the association between cognitive and social deficits, for a better management of patients with neurological disorders.

Lateralized Deficits of Disgust Processing After Insula-Basal Ganglia Damage

A growing body of evidence suggests a role of the insular cortex (IC) and the basal ganglia (BG) in the experience, expression, and recognition of disgust. However, human lesion research, probing this structure-function link, has yielded rather disparate findings in single cases of unilateral and bilateral damage to these areas. Comparative group approaches are needed to elucidate whether disgust-related deficits specifically follow damage to the IC-BG system, or whether there might be a differential hemispheric contribution to disgust processing. We examined emotional processing by means of a comprehensive emotional test battery in four patients with left- and four patients with right-hemispheric lesions to the IC-BG system as well as in 19 healthy controls. While single tests did not provide clear-cut separations of patient groups, composite scores indicated selective group effects for disgust. Importantly, left-lesioned patients presented attenuated disgust composites, while right-lesioned patients showed increased disgust composites, as compared to each other and controls. These findings propose a left-hemispheric basis of disgust, potentially due to asymmetrical representations of autonomic information in the human forebrain. The present study provides the first behavioral evidence of hemispheric lateralization of a specific emotion in the human brain, and contributes to neurobiological models of disgust.

Action perception recruits the cerebellum and is impaired in patients with spinocerebellar ataxia

Our cerebellum has been proposed to generate prediction signals that may help us plan and execute our motor programmes. However, to what extent our cerebellum is also actively involved in perceiving the action of others remains to be elucidated. Using functional MRI, we show here that observing goal-directed hand actions of others bilaterally recruits lobules VI, VIIb and VIIIa in the cerebellar hemispheres. Moreover, whereas healthy subjects (n = 31) were found to be able to discriminate subtle differences in the kinematics of observed limb movements of others, patients suffering from spinocerebellar ataxia type 6 (SCA6; n = 21) were severely impaired in performing such tasks. Our data suggest that the human cerebellum is actively involved in perceiving the kinematics of the hand actions of others and that SCA6 patients’ deficits include a difficulty in perceiving the actions of other individuals. This finding alerts us to the fact that cerebellar disorders can alter social cognition.

Developments in treating the nonmotor symptoms of stroke

INTRODUCTION

Stroke is among the most common causes of disability worldwide. Nonmotor symptoms of stroke are common and disabling. Many are treatable, and intervention improves the quality of life for stroke survivors.

AREAS COVERED

Here the author summarizes the evidence-based treatment of depression and other mood disorders, aphasia, hemispatial neglect, impairments of emotional communication and empathy, deficits in memory and other cognitive functions, sleep disorders, pain, fatigue, and seizures resulting from stroke. The author focuses on treatments supported by randomized controlled trials (RCTs), from the literature cited in Google Scholar, Embase, and Pubmed.

EXPERT OPINION

While behavioral rehabilitation is the most common intervention for many of the sequelae of stroke, relatively small RCTs support the use of noninvasive brain stimulation (transcranial direct current stimulation and transcranial direct current stimulation) and medications that facilitate neural plasticity and recovery. These noninvasive brain stimulation methods remain investigational for post-stroke symptoms. The strongest evidence for pharmacological intervention is in the domains of post-stroke mood disorders and epilepsy, but additional RCTs are needed to confirm the efficacy of selective serotonin reuptake inhibitors and other medications for improving recovery of cognition, language, and energy after stroke.

Impaired Empathy Versus General Hypoemotionality in Frontotemporal Dementia

OBJECTIVE

Impaired empathy is a diagnostic feature of behavioral variant frontotemporal dementia (bvFTD), but it is not clear whether it is caused by a primary impairment in empathy or by general emotional blunting.

METHODS

Patients with bvFTD who met criteria for loss of empathy (N=10) and patients with Alzheimer's disease (N=15) were assessed with a measure for empathy (Socioemotional Dysfunction Scale [SDS]) and a measure for general emotion (Scale for Emotional Blunting [SEB]). All patients underwent neuroimaging. Both patient groups and a healthy control group (N=18) were evaluated by using autonomic responses (skin conductance responses [SCR]) to pictures from the Internal Affective Picture System (IAPS) (presence or absence of empathy stimuli and high versus low emotion).

RESULTS

All participants reported understanding the content and others' perspectives on the empathy pictures; however, only patients with bvFTD showed impaired empathic behavior on the SDS, which persisted after adjusting for measures from the emotion scale (SEB). Patients with bvFTD had significantly lower SCR for all the IAPS stimuli, including for empathy pictures, which also persisted after adjusting for emotional content. On MRI analysis, SCR across groups significantly correlated with the volume of the dorsal anterior cingulate gyrus (dACC).

CONCLUSIONS

These results indicate that patients with bvFTD have decreased empathic behavior with or without emotional blunting, and they exhibit decreased psychophysiological responses to empathy stimuli, independent of general emotion. These preliminary findings suggest a specific impairment in emotional empathy, possibly related to impairment of the emotional appraisal role of the dACC.