Extraordinary altruists exhibit enhanced self-other overlap in neural responses to distress

Abstract

Shared neural representations during experienced and observed distress are hypothesized to reflect empathic neural simulation, which may support altruism. But the correspondence between real-world altruism and shared neural representations has not been directly tested, and empathy’s role in promoting altruism toward strangers has been questioned. Here we show that individuals who have performed costly altruism (donating a kidney to a stranger; n=25) exhibit greater self-other overlap than matched controls (n=27) in neural representations of pain and threat (fearful anticipation) in anterior insula (AI) in an empathic pain paradigm. Altruists exhibited greater self-other correspondence in pain-related activation in left AI, highlighting that group-level overlap was supported by individual-level associations between empathic pain and first-hand pain. Altruists exhibited enhanced functional coupling of left AI with left mid-insula during empathic pain and threat. Results show that heightened neural instantiations of empathy correspond to real-world altruism and highlight limitations of self-report.