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Healthcare experience affects pain-specific responses to others’ suffering in the anterior insula

View ORCID ProfileCorrado Corradi-Dell’Acqua, Christoph Hofstetter, View ORCID ProfileGil Sharvit, View ORCID ProfileOlivier Hugli, View ORCID ProfilePatrik Vuilleumier
doi: https://doi.org/10.1101/2021.07.01.450687
Corrado Corradi-Dell’Acqua
aTheory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland
bGeneva Neuroscience Center, University of Geneva, Geneva, Switzerland
cLaboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
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  • For correspondence: corrado.corradi@unige.ch
Christoph Hofstetter
cLaboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
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Gil Sharvit
cLaboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
dSwiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
eBalgrist University Hospital and University of Zurich, Zurich, Switzerland
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Olivier Hugli
fEmergency Department, University Hospital of Lausanne (UHL), Lausanne, Switzerland
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Patrik Vuilleumier
bGeneva Neuroscience Center, University of Geneva, Geneva, Switzerland
cLaboratory of Behavioural Neurology and Imaging of Cognition, Department of Neuroscience, University Medical Center, University of Geneva, Geneva, Switzerland
dSwiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
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Abstract

Medical students and professional healthcare providers often underestimate patients’ pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self-pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other’s pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self-pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others’ suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others’ pain that is shared with that of first-hand nociception, and related more to AI than to other pain-responsive regions. Taken together, our study suggests a decreased propensity to appraise others’ sufferance as one’s own, associated with a reduced recruitment of pain-specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings.

Competing Interest Statement

The authors have declared no competing interest.

Footnotes

  • The manuscript was changed following peer-review

  • https://osf.io/8bjmq/

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted March 02, 2023.
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Healthcare experience affects pain-specific responses to others’ suffering in the anterior insula
Corrado Corradi-Dell’Acqua, Christoph Hofstetter, Gil Sharvit, Olivier Hugli, Patrik Vuilleumier
bioRxiv 2021.07.01.450687; doi: https://doi.org/10.1101/2021.07.01.450687
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Healthcare experience affects pain-specific responses to others’ suffering in the anterior insula
Corrado Corradi-Dell’Acqua, Christoph Hofstetter, Gil Sharvit, Olivier Hugli, Patrik Vuilleumier
bioRxiv 2021.07.01.450687; doi: https://doi.org/10.1101/2021.07.01.450687

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