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CCN Talk: April 21, 2023

Vitaly Napadow

Vitaly Napadow, PhD, LicAc

Professor, Harvard Medical School; Director, Scott Schoen and Nancy Adams Discovery Center for Recovery from Chronic Pain, Spaulding Rehabilitation Hospital; Director, Center for Integrative Pain NeuroImaging (CiPNI), Martinos Center for Biomedical Imaging, Mass General Hospital

A social neuroscience perspective of the patient/clinician relationship: the role of hyperscan neuroimaging in the art of medicine


The patient-clinician interaction can powerfully shape treatment outcomes such as pain but is often considered an intangible “art of medicine” and has largely eluded scientific inquiry. Although brain correlates of social processes such as empathy and theory of mind have been studied using single-subject designs, specific behavioral and neural mechanisms underpinning the patient-clinician interaction are unknown. Using a two-person interactive design, we have constructed both a fMRI and EEG setup to simultaneously record hyperscan neuroimaging data from patient-clinician dyads, who interacted via live video (for fMRI) or face to face (for EEG), while clinicians treated evoked pain in patients with chronic pain. Our recently published fMRI results (Ellingsen et al., 2020, 2021) showed that patient analgesia was mediated by patient-clinician nonverbal behavioral mirroring and brain-to-brain concordance in circuitry implicated in theory of mind and social mirroring. Dyad-based analyses showed extensive dynamic coupling of these brain nodes with the partners’ brain activity, yet only in dyads with pre-established clinical rapport. These findings introduce a putatively key brain-behavioral mechanism for therapeutic alliance and psychosocial analgesia. This talk will supplement our previously published results with results from ongoing hyperscan EEG studies and introduce future directions for this nascent field of research.