Cognitive and Emotional Empathy and their Neurofunctional Correlates in Autism Spectrum Conditions

Background: According to recent conceptions, empathy can be seen as multidimensional construct consisting of cognitive (inferring mental states) and emotional (empathic concern) components. The neuronal correlates of empathy are largely unknown. Despite a lack of research into its different components, individuals with autism spectrum conditions (ASC) are generally believed to lack empathy.

Objectives: To compare cognitive and emotional empathy and their neuronal correlates of adults with ASC with those of controls.

Methods: A group of 20 adults with ASC (7 women) and 18 controls (5 women) matched for age and IQ underwent fMRI scanning while taking an adaptation of the Multifaceted Empathy Test (MET; Dziobek et al., in press). Using photographic stimuli showing distressed individuals, the test allows for the multidimensional assessment of empathy by demanding mental state inferences (cognitive empathy) and self-evaluation of levels of compassion (emotional empathy).

Results: Between-group analyses of behavioral data revealed that while the ASC group scored lower on the MET’s cognitive empathy scale, there were no differences between groups in the emotional empathy scale. Imaging analyses showed that both groups activated the same differing neuronal networks for cognitive and emotional empathy, respectively: while the superior temporal sulcus region was selectively involved in cognitive empathy, the medial prefrontal cortex, temporoparietal junction, and precuneus were selectively involved in emotional empathy. Group comparisons showed that during the cognitive empathy condition, the ASC group showed significantly more activation in a network encompassing the right amygdala, anterior insula, and orbitofrontal cortex.

Conclusions: On the behavioral as well as brain level, cognitive and emotional empathy represent dissociable functions. Individuals with ASC activate an emotional network including the amygdala when asked to appreciate other’s distress. This activation might reflect aversion and arousal, respectively, when confronting a task demanding the processing of other’s emotions and focusing on another person’s eyes.