The neural networks underlying reappraisal of empathy for pain

Emotion regulation plays a central role in empathy. Only by successfully regulating our own emotions can we reliably use them in order to interpret the content and valence of others’ emotions correctly. In an functional magnetic resonance imaging (fMRI)-based experiment, we show that regulating one’s emotion via reappraisal modulated biased emotional intensity ratings following an empathy for pain manipulation. Task-based analysis revealed increased activity in the right inferior frontal gyrus (IFG) when painful emotions were regulated using reappraisal, whereas empathic feelings that were not regulated resulted in increased activity bilaterally in the precuneus, supramarginal gyrus and middle frontal gyrus (MFG), as well as the right parahippocampal gyrus. Functional connectivity analysis indicated that the right IFG plays a role in the regulation of empathy for pain, through its connections with regions in the empathy for pain network. Furthermore, these connections were further modulated as a function of the type of regulation used: in sum, our results suggest that accurate empathic judgment (i.e. empathy that is unbiased) relies on a complex interaction between neural regions involved in emotion regulation and regions associated with empathy for pain. Thus, demonstrating the importance of emotion regulation in the formulation of complex social systems and sheds light on the intricate network implicated in this complex process

Post-therapy Functional Magnetic Resonance Imaging in Adults with Symptomatic Convergence Insufficiency

SIGNIFICANCE:Prior studies have demonstrated the effectiveness of vergence-accommodative therapy in the treatment of convergence insufficiency (CI). These results show the changes in brain activation following therapy through the use of functional magnetic resonance imaging (fMRI).PURPOSE:The purpose of this study was to investigate changes in brain activation following office-based vergence-accommodative therapy versus placebo therapy for CI using the blood oxygenation level-dependent signal from fMRI.METHODS:Adults (n = 7, aged 18 to 30 years) with symptomatic CI were randomized to 12 weeks of vergence-accommodative therapy (n = 4) or placebo therapy (n = 3). Vergence eye movements were performed during baseline and outcome fMRI scans.RESULTS:Before therapy, activation (z score ≥ 2.3) was observed in the occipital lobe and areas of the brain devoted to attention, with the largest areas of activation found in the occipital lobe. After vergence-accommodative therapy, activation in the occipital lobe decreased in spatial extent but increased in the level of activation in the posterior, inferior portion of the occipital lobe. A new area of activation appeared in the regions of the lingual gyrus, which was not seen after placebo therapy. A significant decrease in activation was also observed in areas of the brain devoted to attention after vergence-accommodative therapy and to a lesser extent after placebo therapy.CONCLUSIONS:Observed activation pre-therapy consistent with top-down processing suggests that convergence requires conscious effort in symptomatic CI. Decreased activation in these areas after vergence-accommodative therapy was associated with improvements in clinical signs such as fusional vergence after vergence-accommodative therapy. The increase in blood oxygen level-dependent response in the occipital areas following vergence-accommodative therapy suggests that disparity processing for both depth and vergence may be enhanced following vergence-accommodative therapy

Imaging of Convergence Insufficiency Treatment Effects (ICITE) Pilot Study: Design and Methods

Background: The blood-oxygen-level-dependent(BOLD) signal from functional magneticresonance imaging (fMRI) identifies brainactivation during specific tasks.1,2 This paperdescribes the design and methodology ofthe Imaging of Convergence InsufficiencyTreatment Effects (ICITE) Study, a two-phasestudy comparing BOLD activations duringvergence eye movements in symptomaticconvergence insufficiency (CI) subjects (1) tothose with normal binocular vision (NBV) and(2) after office-based vergence/accommodativetherapy (OBVAT) versus office-based placebotherapy (OBPT).Methods: Young adults, 18 to 30 years, withNBV or symptomatic CI (near exophoria at least4Δ [prism diopters] greater than at distance,receded near point of convergence [NPC],and insufficient positive fusional vergence[PFV]) were enrolled. During fMRI scanning,subjects were instructed to fuse a random-dotstereogram stimulus with vergence demandsranging from -3Δ to +25Δ. CI subjects werethen randomized to 12 weeks of OBVAT orOBPT. Vision and fMRI examination at outcomewere performed by a masked examiner. BOLDsignal at baseline was compared between NBVand CI patients. Later, the BOLD response atbaseline was compared to that following visiontherapy for those with CI.Conclusion: The imaging results are expectedto advance understanding of neurologicalmechanisms of CI and the effects of therapyon the vergence system, which in turn mayguide development of future research thatcould lead to new treatment strategies