Cry for her or cry with her: context-dependent dissociation of two modes of cinematic empathy reflected in network cohesion dynamics

Two empathy-related processes were recently distinguished neuroscientifically: automatic embodied-simulation (ES) based on visceromotor representation of another's affective state via cingulo-insulary circuit, and emotional sharing relying on cognitive 'theory of mind' (ToM) via prefrontal-temporo-parietal circuit. Evidence that these regions are not only activated but also function as networks during empathic experience has yet to been shown. Employing a novel approach by analyzing fMRI fluctuations of network cohesion while viewing films portraying personal loss, this study demonstrates increased connectivity during empathic engagement (probed by behavioral and parasympathetic indices) both within these circuits, and between them and a set of limbic regions. Notably, this effect was context-dependent: when witnessing as a determined-loss presented as a future event, the ToM and ToM-limbic cohesion positively correlated with state- and empathy indices. During the dramatic peak of this condition, the ToM cohesion was positively correlated with the trait-empathy index of personal distress. However, when the loss was presented as a probabilistic real-time occurrence, ToM cohesion negatively correlated with state-empathy index, which positively correlated with ES-limbic cohesion. In this case, it was the ES-limbic cohesion during the emotional peak which was correlated with personal distress scores. The findings indicate a dichotomy between regulated empathy toward determined-loss and vicarious empathy toward a real-time occurrence.