Transcranial magnetic stimulation highlights the sensorimotor side of empathy for pain


Pain is intimately linked with action systems that are involved in observational learning and imitation. Motor responses to one's own pain allow freezing or escape reactions and ultimately survival. Here we show that similar motor responses occur as a result of observation of painful events in others. We used transcranial magnetic stimulation to record changes in corticospinal motor representations of hand muscles of individuals observing needles penetrating hands or feet of a human model or noncorporeal objects. We found a reduction in amplitude of motor-evoked potentials that was specific to the muscle that subjects observed being pricked. This inhibition correlated with the observer's subjective rating of the sensory qualities of the pain attributed to the model and with sensory, but not emotional, state or trait empathy measures. The empathic inference about the sensory qualities of others' pain and their automatic embodiment in the observer's motor system may be crucial for the social learning of reactions to pain.

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Figure 1: MEP amplitude with respect to the baseline during observation of 'Needle in FDI', 'Q-tip on FDI' and 'Non-corporeal' conditions of experiment 1.
Figure 2: MEPs amplitude with respect to the baseline during observation of 'Needle in foot' and 'Q-tip on foot' conditions of experiment 2.
Figure 3: MEP amplitude recorded from the FDI (black bars) and the ADM (white bars) muscles during the observation conditions of experiment 3.
Figure 4: Amplitude changes of MEPs recorded from the FDI muscle and subjective ratings (z-scores) of the pain ascribed to the model during the 'Needle in FDI' condition in experiment 1.
Figure 5: Amplitude changes of MEPs recorded from the ADM muscle and subjective ratings (z-scores) of the pain attributed to the model during the 'Needle in ADM' condition in experiment 3.
Figure 6: Amplitude changes of MEPs recorded from the FDI muscle during 'Needle in FDI' observation and state (a,b,c,d) and trait (e,f) empathy measures (z-scores) in experiment 5.


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This research was supported by grants from the Ministero Istruzione Università e Ricerca and Finanziamento Italiano Ricerca di Base, Italy, both awarded to S.M.A.

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Corresponding author

Correspondence to Salvatore M Aglioti.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Fig. 1

Examples of raw MEP amplitudes for each observation condition in a representative subject of experiment 1. (JPG 34 kb)

Supplementary Fig. 2

Sensory and affective qualities of the pain supposedly felt by the model during observation of the different types of video clips in experiments 1, 2 and 3. (JPG 68 kb)

Supplementary Fig. 3

Self-oriented emotional reactions during observation of the different movies of experiment 1 measured by means of VAS. (JPG 81 kb)

Supplementary Fig. 4

MEP amplitude recorded from the FDI (black bars) and the ADM (white bars) muscles during the observation of 'Needle in FDI' condition of experiment 5 (expressed with respect to the correspondening static condition). (JPG 29 kb)

Supplementary Table 1

Mean amplitude (± s.e.m.) of F and M waves recorded from the FDI muscle in experiment 4. (JPG 32 kb)

Supplementary Table 2

Simple correlations between MEP amplitude changes recorded from FDI and ADM muscles and subjective ratings of 'Needle in FDI' video clips of experiment 1 and 5, and 'Needle in ADM' video clips of experiment 3. (PDF 44 kb)

Supplementary Video 1

Representative video clips showing the dynamic conditions of experiment 1: (i) a needle entering a right hand ('Needle in FDI'), (ii) a Q-Tip touching the right hand in regions overlapping those pricked by the needle ('Q-Tip on FDI') and (iii) a needle entering a tomato ('Non-Corporeal'). (MOV 2299 kb)

Supplementary Note (PDF 73 kb)

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Avenanti, A., Bueti, D., Galati, G. et al. Transcranial magnetic stimulation highlights the sensorimotor side of empathy for pain. Nat Neurosci 8, 955–960 (2005).

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