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It is likely that the emotional deficits of somatoform disorder patients are linked to disturbed empathic abilities; however, little is known so far about empathic deficits of somatoform patients and the underlying neural mechanisms. We used fMRI and an empathy paradigm to investigate 20 somatoform disorder patients and 20 healthy controls. The empathy paradigm contained facial pictures expressing anger, joy, disgust, and a neutral emotional state; a control condition contained unrecognizable stimuli. In addition, questionnaires testing for somatization, alexithymia, depression, empathy, and emotion recognition were applied. Behavioral results confirmed impaired emotion recognition in somatoform disorder and indicated a rather distinct pattern of empathic deficits of somatoform patients with specific difficulties in \u201cempathic distress.\u201d In addition, somatoform patients revealed brain areas with diminished activity in the contrasts \u201call emotions\u201d\u2013\u201ccontrol,\u201d \u201canger\u201d\u2013\u201ccontrol,\u201d and \u201cjoy\u201d\u2013\u201ccontrol,\u201d whereas we did not find brain areas with altered activity in the contrasts \u201cdisgust\u201d\u2013\u201ccontrol\u201d and \u201cneutral\u201d\u2013\u201ccontrol.\u201d Significant clusters with less activity in somatoform patients included the bilateral parahippocampal gyrus, the left amygdala, the left postcentral gyrus, the left superior temporal gyrus, the left posterior insula, and the bilateral cerebellum. These findings indicate that disturbed emotional empathy of somatoform disorder patients is linked to impaired emotion recognition and abnormal activity of brain regions responsible for emotional evaluation, emotional memory, and emotion generation. Hum Brain Mapp, 2012. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/hbm.21392","type":"journal-article","created":{"date-parts":[[2011,10,13]],"date-time":"2011-10-13T13:23:25Z","timestamp":1318512205000},"page":"2666-2685","source":"Crossref","is-referenced-by-count":47,"title":["Altered brain activity during emotional empathy in somatoform disorder"],"prefix":"10.1002","volume":"33","author":[{"given":"Moritz","family":"de Greck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Scheidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette F.","family":"B\u00f6lter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Frommer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Stockum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Enzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Tempelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihui","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Northoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.20-07-02683.2000"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000289067"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(94)90006-X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2006.05.024"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0786-10.2010"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.42.3.235"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1961.01710120031004"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2005.09.040"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2002.1220"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/122.5.883"},{"key":"e_1_2_7_12_1","volume-title":"Florida Affect Battery: Center for Neuropsychological Studies, Cognitive Neuroscience Laboratory","author":"Bowers D","year":"1999"},{"key":"e_1_2_7_13_1","volume-title":"Attachment and Loss: Vol. 2. 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