Abstract WP431: Acute Stroke in Right Anterior Insula and Frontal Operculum Impair Empathy

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Introduction: Emotional empathy includes emotional contagion (sharing another’s feelings) and perspective-taking (inferring another’s feelings). Earlier studies show that right hemisphere stroke (RHS) can cause impaired perspective-taking. However, studies have not identified stroke lesions associated with impaired emotional contagion.

Hypothesis: Acute infarcts in specific frontal, temporal, or limbic regions disrupt emotional contagion, measured with skin conductance response (SCR; a sensitive measure of emotional response), as well as perspective-taking.

Methods: Participants (9 acute RHS, 9 age-matched controls) played a “roulette” game and watched a partner play. We measured SCR to winning and losing. They rated the emotions (happy to sad) of themselves and their partner when they won and lost money. A neurologist blind to behavioral responses measured percent damage to 10 frontal, temporal, and limbic regions of interest (ROI) on DWI after registration to an atlas. We evaluated differences in group means with unpaired t-tests and differences between ratings of emotions for wins versus losses with paired t-tests. We evaluated associations between SCR magnitude and percent damage to ROI with Spearman correlations.

Results: SCR magnitude was significantly lower in response to both wins and losses in patients with right anterior insula (AI) or inferior frontal gyrus opercularis (IFGop) lesions, compared to those without these lesions, when they played or watched partner play (p=0.0001 to 0.008). SCR to partner winning or losing negatively correlated percent damage to insula (rho=-.64;p=0.005) and IFGop (rho=-.47; p=0.045). Controls and patients without AI or IFGop lesions rated partners and themselves as significantly happier when they won versus lost (p<0.0001); but patients with AI or IFGop lesions showed no difference in ratings for wins vs. losses. The difference between ratings for wins vs. losses negatively correlated with percent damage to AI (rho=-.75; p=0.0005) and IFGop (rho=-.80; p=0.0001) but not total infarct volume (rho=-.46; ns).

Conclusions: Acute right AI and IFGop infarcts are associated with impaired emotional contagion measured with SCR and perspective-taking.

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