To what extent do we share the pain of others? Insight from the neural bases of pain empathy

In the representationalist framework generally adopted in cognitive neuroscience, pain is conceived as a subjective experience triggered by the activation of a mental representation of actual or potential tissue damage (nociception). This representation may involve somatic sensory features, as well as affective-motivational reactions associated with the promotion of protective or recuperative visceromotor and behavioral responses. Mental representation of nociception may provide the primary referent from which a rich associative network can be established to evoke the notion of pain in the absence of a nociceptive stimulus. Here, we adopt the notion of a mental representation of pain as a means to relate the experience of pain in oneself to the perception of pain in others. We review the functional neuroimaging studies supporting the hypothesis that the perception of pain in others relies at least partly on the activation of a mental representation of pain in the Self, and thus on common neural systems. However, we also demonstrate that there are systematic differences in activation sites within painrelated areas that must be considered for a better understanding of the mechanisms underlying pain empathy