The effects of exergaming on empathy for pain: Evidence from an event-related potential study

Although aerobic exercise modulates self-experienced pain, its impact on empathy for pain remains unclear. Moreover, whether exergaming, which combines exercise with interactive gaming, influences empathy-related neural responses is unknown. The present study investigated the effects of exergaming on the neural mechanisms underlying empathy for pain, comparing them with those of conventional aerobic exercise (cycling) and a non-active control condition. A total of ninety-one participants were randomly assigned to one of three conditions: exergaming (Nintendo Fitness Ring Adventure), moderate intensity cycling, or rest. After a 30-min intervention, participants completed a pain judgement task while event-related potentials (ERP) were recorded. Behavioral outcomes (reaction time, accuracy, pain intensity, and emotional valence ratings) and ERP components (N1, P2, N2, P3, LPP) were analyzed. Results revealed that both exergaming and cycling enhanced emotional valence ratings for painful images relative to the control condition. ERP analyses demonstrate that exergaming significantly amplified late-stage components (P3 and LPP) in response to painful stimuli, indicating enhanced cognitive appraisal processes associated with empathy for pain, while early components (N1, P2, N2) remain unaffected across conditions. These findings suggest that exergaming, through its combination of multisensory and cognitive engagement, uniquely enhances cognitive empathy for pain.