(a) Frames extracted from a Hand and a Face movie. For the Face, the first second of each movie showed a neutral facial expression, the second, the facial reaction to the shock. For the Hand, the movie started with the belt resting on the hand. The first second showed the belt lifting and coming down again, to hit the hand at the 1 s mark exactly. The hand then reacted to the force of the belt. Both the slap and the shock delivery happened in the middle of the movies, splitting them into a 1 s neutral and a 1 s pain period. (b) Single-trial structure diagram. After the presentation of each video, patients expressed their choice at their pace using the keyboard keys f, g, j, and k for pain intensities 1–2, 3–4, 5–6, and 7–8, respectively. ITI started with participant’s response. (c) Position (i.e., the midpoint between two adjacent electrodes) of the 85 bipolar macroelectrode recording sites shown as dots and of the microelectrode locations shown as pluses, color-coded by patient. Data from the two hemispheres and all lateromedial coordinates are projected here onto a single sagittal slice of the insula taken at X = 38 from the brain of one of the patients. For a list of all MNI coordinates, see Figure 1—source data 1. (d) Graphical illustration of how a bipolar recording for one patient and one insular electrode was computed. In green, the CT, and in gray, the T1 scan from patient C. The annular structures along the electrode shaft in the CT correspond to individual macroelectrode contacts (green 1, 2, 3 …). Recordings from adjacent pairs of contacts along the electrode were subtracted to calculate bipolar recordings (white 1–2, 2–3 …). (e) From left to right, Spearman’s correlation coefficient r, intercept, and slope values from the linear regression for Hand (green) and Face (purple). Histograms: values for the control group illustrate the similarity between the ratings of each participant in the control group and the average of the other controls, and are shown as gray; the similarity between each of the seven patients with the average of the control group is shown in colors. Dotted lines mark the 2.5 and 97.5% of the control group. Bar graphs: mean ± SEM of the controls (gray) and the seven included patients (color) with individual patients as circles. In the bar graphs, we also show as Xs the corresponding behavioral performance metrics of the two patients that were excluded due to atypical use of the response keys. These patients were not included in the mean and SEM calculations.