Chronic Pain Modulates Empathic Responses in People with Spinal Cord Injury

<b>Background/Objectives:</b> While the correlation between bodily states and cognitive processing has been extensively investigated concerning pain elaboration, little is known about how chronic, subjectively experienced pain (self-pain) following traumatic spinal cord injury (SCI) affects embodied cognition, such as empathy for pain. This study aimed to determine whether individuals with SCI differ from healthy controls in these cognitive responses, and if such differences can be quantified through varying reaction times to pain-related and non-pain-related stimuli involving others. <b>Methods:</b> We assessed reactions to others' pain through behavioral responses in a classification task involving 15 participants with SCI (13 men; age range 19-56 years) and 15 healthy controls (11 men; age range 25-48 years). Additionally, we measured general empathic dispositions using the Interpersonal Reactivity Index (IRI) and subjective pain intensity using a numeric rating scale following standard guidelines for neuropathic pain assessment. <b>Results:</b> The findings revealed that participants with SCI exhibited lower empathy levels (IRI: mean SCI = 55.06 ± 3.64) than healthy controls (IRI: mean HC = 67.6 ± 2.46), as measured through both cognitive and affective components. We found that higher chronic pain unpleasantness was associated with lower empathic dispositions (r = -0.63; <i>p</i> = 0.01) in participants with SCI. Compared to healthy controls, individuals with SCI exhibited a reduced empathic response when observing others in pain from a third-person perspective. <b>Conclusions:</b> These findings reveal an association between chronic pain following SCI and diminished empathic processing, offering new insights into the mechanisms underlying interpersonal reactivity after SCI.