Perceiving the pain of others activates a large part of the pain matrix in the observer [1Jackson P.L. Rainville P. Decety J. To what extent do we share the pain of others? Insight from the neural bases of pain empathy.Pain. 2006; 125: 5-9Abstract Full Text Full Text PDF PubMed Scopus (232) Google Scholar]. Because this shared neural representation can lead to empathy or personal distress [2Decety J. Lamm C. Human empathy through the lens of social neuroscience.ScientificWorldJournal. 2006; 6: 1146-1163Crossref PubMed Scopus (511) Google Scholar, 3Lamm C. Batson C.D. Decety J. The neural substrate of human empathy: Effects of perspective-taking and cognitive appraisal.J. Cogn. Neurosci. 2007; 19: 42-58Crossref PubMed Scopus (855) Google Scholar], regulatory mechanisms must operate in people who inflict painful procedures in their practice with patient populations in order to prevent their distress from impairing their ability to be of assistance. In this functional magnetic resonance imaging MRI study, physicians who practice acupuncture were compared to naive participants while observing animated visual stimuli depicting needles being inserted into different body parts, including the mouth region, hands, and feet. Results indicate that the anterior insula somatosensory cortex, periaqueducal gray, and anterior cingulate cortex were significantly activated in the control group, but not in the expert group, who instead showed activation of the medial and superior prefrontal cortices and the temporoparietal junction, involved in emotion regulation and theory of mind.
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