Brain responses to dynamic facial expressions of pain

Department of Biological and Clinical Psychology, Friedrich-Schiller-University, Jena, Germany.
Pain (Impact Factor: 5.21). 01/2007; 126(1-3):309-18. DOI: 10.1016/j.pain.2006.08.033
Source: PubMed


The facial expression of pain is a prominent non-verbal pain behaviour, unique and distinct from the expression of basic emotions. Yet, little is known about the neurobiological basis for the communication of pain. Here, subjects performed a sex-discrimination task while we investigated neural responses to implicit processing of dynamic visual stimuli of male or female faces displaying pain or angry expressions, matched on expression intensity and compared to neutral expression. Stimuli were presented in a mixed blocked/event-related design while blood oxygenation level dependent (BOLD) signal was acquired using whole-brain functional magnetic resonance imaging (fMRI) at 1.5 Tesla. Comparable sustained responses to pain and angry faces were found in the superior temporal sulcus (STS). Stronger transient activation was also observed to male expression of pain (Vs neutral and anger) in high-order visual areas (STS and fusiform face area) and in emotion-related areas including the amygdala (highest peak t-value=10.8), perigenual anterior cingulate cortex (ACC), and SI. Male pain compared to anger expression also activated the ventromedial prefrontal cortex, SII/posterior insula and anterior insula. This is consistent with the hypothesis that the implicit processing of male pain expression triggers an emotional reaction characterized by a threat-related response. Unexpectedly, several areas responsive to male expression, including the amygdala, perigenual ACC, and somatosensory areas, showed a decrease in activation to female pain faces (Vs neutral). This sharp contrast in the response to male and female faces suggests potential differences in the socio-functional role of pain expression in males and females.

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    • "Participants were scored according to whether or not they correctly identified the facial expression depicted, which was averaged across each of the four emotion categories. A dynamic version of the above-described emotion recognition task was created using standardized stimuli of dynamic, prototypical facial expressions from the Montréal Pain and Affective Face Clips (MPAFC) database (see Simon et al. 2006). Participants viewed a series of 40 1-s dynamic visual stimuli depicting a man or woman (20 of each sex) whose facial expression morphed from neutral to one of five expressions: anger, fear, happiness, sadness, and pain. "
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    • "The vicarious activation to viewing others' facial expressions of these sensorimotor brain regions has thus been interpreted as representing an internal simulation of the sensorimotor neural activity associated with producing the observed facial expressions (Bastiaansen et al., 2009; Said et al., 2011; van der Gaag et al., 2007). When witnessing facial expressions of pain, participants have been shown to additionally activate regions of the anterior insula (AI), anterior cingulate cortex (ACC) and the amygdala (Botvinick et al., 2005; Saarela et al., 2007; Simon et al., 2006). Because the AI, ACC and amygdala are part of the pain-matrix — the set of brain regions that are activated when the participants themselves are exposed to noxious stimuli on their body (Garcia-Larrea and Peyron, 2013; Melzack and Wall, 1965; Mouraux et al., 2011) — and because their level of activation during the experience of pain correlates with the unpleasantness of experienced pain (Rainville, 2002), many interpret their vicarious activation while witnessing the pain of others as the neural correlate of empathy — feeling vicariously what we see someone else to experience (Corradi-Dell'Acqua et al., 2011; Jackson et al., 2006; Koban et al., 2013; Lamm et al., 2011; Singer et al., 2004). "
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