People with damage to anterior insular cortex have a hard time grasping the emotional states of someone in pain, and consequently are not able to feel empathy for them. This study offers evidence that the lack of empathy in those with brain damage to the anterior insular cortex are "surprisingly similar to the empathy deficits found in several psychiatric diseases, including autism spectrum disorders, borderline personality disorder, schizophrenia, and conduct disorders, suggesting potentially common neural deficits in those psychiatric populations."
Full Citation:
X. Gu, Z. Gao, X. Wang, X. Liu, R. T. Knight, P. R. Hof, J. Fan. Anterior insular cortex is necessary for empathetic pain perception. Brain, 2012; 135 (9): 2726 DOI: 10.1093/brain/aws199
Area of the Brain That Processes Empathy Identified
An international team led by researchers at Mount Sinai School of Medicine in New York has for the first time shown that one area of the brain, called the anterior insular cortex, is the activity center of human empathy, whereas other areas of the brain are not. The study is published in the September 2012 issue of the journal Brain.
Empathy, the ability to perceive and share another person's emotional state, has been described by philosophers and psychologists for centuries. In the past decade, however, scientists have used powerful functional MRI imaging to identify several regions in the brain that are associated with empathy for pain. This most recent study, however, firmly establishes that the anterior insular cortex is where the feeling of empathy originates.
"Now that we know the specific brain mechanisms associated with empathy, we can translate these findings into disease categories and learn why these empathic responses are deficient in neuropsychiatric illnesses, such as autism," said Patrick R. Hof, MD, Regenstreif Professor and Vice-Chair, Department of Neuroscience at Mount Sinai, a co-author of the study. "This will help direct neuropathologic investigations aiming to define the specific abnormalities in identifiable neuronal circuits in these conditions, bringing us one step closer to developing better models and eventually preventive or protective strategies."
Xiaosi Gu, PhD, who conducted the research in the Department of Psychiatry at Mount Sinai, worked with researchers from the United States and China, to evaluate Chinese patients, at Beijing Tiantan Hospital, who were shown color photographs of people in pain. Three patients had lesions caused by removing brain tumors in the anterior insular cortex; nine patients had lesions in other parts of the brain and 14 patients (the controls) had neurologically intact brains. The research team found that patients with damage restricted to the anterior insular cortex had deficits in explicit and implicit empathetic pain processing.
"In other words, patients with anterior insular lesions had a hard time evaluating the emotional state of people in pain and feeling empathy for them, compared to the controls and the patients with anterior cingulate cortex lesions." said Dr. Jin Fan, corresponding author of this study and an assistant professor at the Department of Psychiatry at Mount Sinai.
According to Dr. Gu, this study provides the first evidence suggesting that the empathy deficits in patients with brain damage to the anterior insular cortex are surprisingly similar to the empathy deficits found in several psychiatric diseases, including autism spectrum disorders, borderline personality disorder, schizophrenia, and conduct disorders, suggesting potentially common neural deficits in those psychiatric populations.
"Our findings provide strong evidence that empathy is mediated in a specific area of the brain," said Dr. Gu, who now works at University College London. "The findings have implications for a wide range of neuropsychiatric illnesses, such as autism and some forms of dementia, which are characterized by prominent deficits in higher-level social functioning."
This study suggests that behavioral and cognitive therapies can be developed to compensate for deficits in the anterior insular cortex and its related functions such as empathy in patients. These findings can also inform future research evaluating the cellular and molecular mechanisms underlying complex social functions in the anterior insular cortex and develop possible pharmacological treatments for patients.
The study was funded by the National Institute of Health, the James S. McDonnell Foundation and a Brain and Behavior Research Foundation NARSAD young investigator award.
2 comments:
I am on the autism spectrum, and it upsets me that NTs do not know how to make the distinction between being able to be empathetic and experiencing empathy and being able to read various situations that would ask for empathy or knowing how to express it.
When feelings would naturally, logically flow from a set of circumstances, I have an appropriate empathetic response and I feel empathy. (Not saying that all autistics do, but because someone is not expressing it doesn't mean they don't feel it.)
When people are hurt because of irrational feelings, without knowing more, YES, I have trouble reading their hurt. I'm not sure if it is hurt or displeasure toward me.
One thing I've learned, though, if you ask NTs why they are behaving the way they are behaving (or simple things like "Is there something wrong?"), most of them think you are being disingenuous, they behave as if you should read their minds and know what is wrong. And they frequently lie by saying things are "fine." If you hit the head directly on the nail and tell them what you think you are seeing (just trying to understand mind you so you can know how to respond), they will tell you that you are wrong (particularly if what you are picking up with sounds irrational if mirrored back to them even if you don't make light of their feelings or point out that the thoughts behind them are irrational). Later, you might get told you were right, but not in a good way. In a back handed way with the twist of a knife in your gut.
So over the years, I've learned to try to allow NTs to be responsible for communicating with me, to behave as adults, to state what's bothering them, to be direct, rather than worrying after them with questions that seem to annoy them.
As a result, I appear to be either a co-dependent hanger on or a narcissist who doesn't care how they think. NO... I just do not know how to play the NT game... I can't read their faces unless I understand the context or what is motivating them.
Regardless of how straight forward I am with them about my needs and expectations, they expect me to read their minds and their faces without telling me all while casting aspersions on my character or failing to think and read situations like them. It's not that I do not feel empathy for them. To continue on asking questions and getting mostly lies is crazy making.
The way NT researchers look at empathy and autism, at least, like saying a blind man can't read because he can't see. If he has braille and knows that language, he can read.
For many of us on the autism spectrum, responding empathetically is a language issue based on an inability to read (and/or an inability to understand the response needed based on cues we've missed in the past that tell us one false move could get us into a whole lot of trouble). It is NOT necessarily an inability to be empathetic. I wish NT researchers could understand this distinction!!!
"The way NT researchers look at empathy and autism, at least, like saying a blind man can't read because he can't see. If he has braille and knows that language, he can read." The comment containing that is mine.
I would have more to say about the failure to address pathogens and their link to genetics, but that's a whole 'nother ball of wax.
However, I do want to add:
Our brains may be organized differently, but that does not mean that we are necessarily incapable of empathy or empathetic responses. It means that we socialize differently than NTs at times (sometimes or most of the time) in ways they find confusing.
To get to a point where we are confident in ourselves and not self loathing in a world that does not understand our different way of being is quite an accomplishment. The reason for the self loathing is all the negative flak and pressure to conform that we get being the way we are. It takes a lot of work to overcome the negative messages received in early life.
Those of us with Autism are busy speaking two languages as best we can (peddling as fast as we can), with NT as a second language done blind in many cases, and NTs are speaking one language.
To top it off, many of us are painted with the "able to memorize" brush/stereotype. We are expected to memorize social rules with NTs having little appreciation for how dynamic those rules are. And if you have trouble reading faces, then it really doesn't even matter if you've memorized the social rules... the faces aren't giving you any clue about the changing dynamic... only a vague sense that something is off (if you even get that) will tell you (but refer to above why it is generally useless to ask anyone about your sense that something is off).
So many of us have worked through a number of the big rules in an effort to fit in However, being totally oblivious to what we may be missing, we know if we blunder at what is known to be an obvious rule to NTs, assumptions will be made about our character. If you are really smart and all of a sudden appear quite stupid, NTs don't believe it. Your behavior must be an intentional slight or have some other heinous motivation.
It's a wonder any of us learn to fit in at all. Fitting in society, however, does not necessarily mean we ever learn to negotiate the mind field of Asperger/NT relationships.
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