The phenomenon of empathy has been fascinating laymen and scholars for centuries and has recently been an important subject for cognitive neuroscientific study. Empathy refers to the ability to understand and share others’ emotions and a characteristic of this ability is the capacity to empathize with others in pain. This review intends to examine and read up on the current state of the field of the neural and behavioral mechanisms associated with empathy for pain. The neural underpinnings of the first-hand experience of pain have been shown to be activated in a person observing the suffering individual, and this similarity in brain activity has been referred to as shared networks. This phenomenon plays an important role in the study of empathy. However, different factors have been shown to influence empathy for pain, such as age, gender, affective link between observer and sufferer, as well as phylogenetic similarity. This thesis discusses these differences, as well as atypical aspects affecting the empathic ability such as synaesthesia for pain, psychopathy and Asperger’s disease. Further, empathy for pain can be modulated by the individual observing someone in pain. For example, caregivers often down-regulate their empathic response to patients in pain, possibly in order to focus on their treatment and assistance. Also, paying attention to harmful stimuli heightens the perception of pain; therefore, the painful experience can be less remarkable when focusing on something else. The effect of empathy from others directed to oneself when suffering is discussed, as well as the consistency and limitations of presented research.

La douleur sociale est une forme de douleur non physique dérivant de la perception de l'exclusion sociale. L'importance de la compréhension de ses modulations comportementales et neuronales est fondamentale, car ses conséquences sur le long terme peuvent être très néfastes. Dans ce travail de thèse, j'ai exploré ces aspects à travers une étude comportementale à l‟aide d‟enregistrements par SCR (Skin Conductance Recording), et trois études en iEEG (électro-encéphalographie intracrânienne) chez des patients épileptiques. La première étude comportementale a exploré la direction dans laquelle l'exclusion sociale est influencée par une récompense et ses réactions sur le long terme. Ainsi, la récompense monétaire altère l'équilibre social et augmente l‟activité électrodermale. La personne ayant été exclue met alors en oeuvre des mécanismes de vengeance en défavorisant la personne qui l‟a exclue précédemment. Les études en iEEG ont été une fenêtre unique d'exploration du cerveau lors de différentes types de modulation de l'exclusion. Dans la première étude en iEEG, nous avons observé que la douleur sociale produit une activation des oscillations thêta (3-7 Hz), lors de d'exclusion, dans l'insula, l'ACC, le cortex préfrontal et le gyrus fusiforme. La deuxième étude iEEG s'est intéressée aux modulations produites par la douleur sociale dans BA 19 et BA 17 présentant des P1 d'amplitude majeure lors de l'observation des photos du joueur qui exclut. La troisième étude en iEEG a exploré la réponse neuronale de l'influence d'une variable monétaire lors de l'exclusion. Nos résultats démontrent que l'insula postérieure présente une activation thêta indépendante du fait que l'exclusion soit positive (exclusion et gain d'argent) ou encore négative (exclusion et perte d'argent), à la différence de l'insula antérieure, active seulement lors d'une exclusion négative / Pain is a form of social non-physical pain arising from the perception of social exclusion. The importance of understanding its behavioral and neuronal modulations has a critical value, since its long lasting consequences can be extremely harmful. In this thesis I firstly explored these issues through a behavioral SCR study (Skin Conductance Recording), and successively through three iEEG studies in patients with epilepsy (intracranial EEG). The SCR study explored the direction in which social exclusion is influenced by a reward and its long lasting reactions. Money affects social equilibrium and increases the SCR pics. The excluded individual implements revenge attitudes toward the person who excluded in a previuous interaction. The iEEG studies were a unique window for exploring the brain during different types of social pain modulations. In the first iEEG study, we found that social pain produced activation of theta oscillations (3-7 Hz) during exclusion in the insula, in the ACC, in the prefrontal cortex and in the fusiform face area. The second iEEG study wanted to explore deeply the primitive modulations produced by social pain in visual area. We found in BA 19 and BA 17 greater P1 peak amplitude during excluder pictures presentation. The third iEEG study investigated the neuronal modulations produced by a monetary reward during social pain. These results demonstrated that the posterior insula has a theta activation independent of whether the exclusion is positive (excluded but gaining money) or more negative (excluded but losing money), whereas the anterior insula, has a theta activation only during a negative exclusion