The Neuroimaging of Vicarious Pain

  • Esslin L. Terrighena
  • Tatia M. C. LeeEmail author


The similarities between self-experienced and vicarious pain have led research to suggest that both experiences may be facilitated by shared neural representations. Indeed, neuroimaging evidence demonstrates an overlap in neural patterns during self- and other-pain. Such comparable brain activity may facilitate an empathic understanding of the current state of the individual in pain by stimulating relevant pain associations in the own sensory, affective and cognitive systems. However, research further shows the distinct contributions of neural activity during vicarious pain processing, in particular in brain regions related to perspective-taking, attention and top-down response regulation. Likewise, such activity may underpin response formation to the observed pain, such as empathic or withdrawal behaviors. This chapter reviews 31 fMRI, six EEG/MEG and four TMS studies exploring the neural correlates of vicarious pain in healthy individuals. Both shared and distinct neural contributions to stimulus and response processing during vicarious pain are discussed. Notably, an integrative model of vicarious pain is introduced which brings such contributions together in a comprehensive manner. Moreover, the chapter highlights inconsistencies and research gaps in current literature with the aim of stimulating further scientific investigation. This is pertinent to the detection of neurobiological markers and intervention targets for empathic deficits which characterize a wide variety of clinical health issues.


Empathic Perception-action model (PAM) Motor cortex Self-pain Mirror neuron 


Brain Regions


Inferior Frontal Gyrus


Inferior Parietal Lobule


Primary Somatosensory Cortex, Secondary Somatosensory Cortex


Prefrontal Cortex




Anterior Insula, Mid-Insula, Posterior Insula


Cingulate Cortex, Anterior Cingulate Cortex, Posterior Cingulate Cortex


subgenual ACC, rostral ACC


Midcingulate Cortex, Anterior MCC

dlPFC, dmPFC, mPFC, rlPFC

dorsolateral PFC, dorsomedial PFC, medial PFC, rostrolateral PFC


Supplementary Motor Area

Neuroimaging Methods


functional Magnetic Resonance Imaging






Transcranial Magnetic Stimulation



Perception Action Model



This work was supported by the May Endowed Professorship of The University of Hong Kong, the Research Grants Council Humanities and Social Sciences Prestigious Fellowship (Ref: HKU703-HSS-13). The funders have no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Laboratory of NeuropsychologyThe University of Hong KongPok Fu LamHong Kong SAR
  2. 2.Laboratory of Social Cognitive Affective NeuroscienceThe University of Hong KongPok Fu LamHong Kong SAR
  3. 3.The State Key Laboratory of Brain and Cognitive SciencesThe University of Hong KongPok Fu LamHong Kong SAR
  4. 4.Institute of Clinical NeuropsychologyThe University of Hong KongPok Fu LamHong Kong SAR

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