title: Empathic deficits in combat veterans with traumatic brain injury:  a voxel-based lesion-symptom mapping study.
abstract: OBJECTIVE
  To understand better which brain regions support emotional empathy.
  
  
  BACKGROUND
  Emotional empathy, the ability to interpret and share the affective states of others, is a key component in human social interaction. Previous research has suggested that emotional empathy relies on several distinct brain regions, although further evidence from human lesion studies is needed to determine which regions are critical.
  
  
  METHODS
  We studied 192 male Vietnam combat veterans who had sustained focal penetrating traumatic brain injuries, and 54 non-brain-injured veterans. We used voxel-based lesion-symptom mapping on computed tomographic scans to elucidate the neural bases of self-reported emotional empathy as measured by the Balanced Emotional Empathy Scale.
  
  
  RESULTS
  Damage in several brain regions, particularly the ventrolateral prefrontal cortex, left and right posterior temporal lobes, and insula, was associated with diminished emotional empathy.
  
  
  CONCLUSIONS
  These findings provide further insight into the neural substrates of emotional empathy, and are consistent with the notion that emotional empathy is supported by a distributed network of brain regions. Additional work may advance our understanding of the empathic deficits commonly observed in patients with neurologic and psychiatric disorders.
authors.affiliation: Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. david.driscoll@va.gov
authors.forename: David M
authors.initials: DM
authors.lastname: Driscoll
authors.forename: Olga
authors.initials: O
authors.lastname: Dal Monte
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Solomon
authors.forename: Frank
authors.initials: F
authors.lastname: Krueger
authors.forename: Jordan
authors.initials: J
authors.lastname: Grafman
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D001931:Brain Mapping; D004644:Emotions / Q000502:physiology; D004645:Empathy / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011859:Radiography; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict