While empathy to the pain of conspecific is evolutionary-ancient and is observed in rodents and in primates, it also integrates higher-order affective representations. Yet, it is unclear whether human empathy for pain is inborn or matures during development and what neural processes underpin its maturation. Using magnetoencephalography, we monitored the brain response of children, adolescents, and adults (n = 209) to others' pain, testing the shift from childhood to adult functioning. Results indicate that children's vicarious empathy for pain operates via rudimentary sensory predictions involving alpha oscillations in somatosensory cortex, while adults' response recruits advanced mechanisms of updating sensory predictions and activating affective empathy in viceromotor cortex via higher-level representations involving beta-and gamma-band activity. Our findings suggest that full-blown empathy to others' pain emerges only in adulthood and involves a shift from sensory selfbased to interoceptive other-focused mechanisms that support human altruism, maintain self-other differentiation, modulate feedback to monitor other's state, and activate a plan of action to alleviate other's suffering.Empathy is a multifaceted phenomenon most commonly considered from the perspectives of shared affect or cognitive mentalization 1-3 ; the first being more rudimentary and evolutionary-ancient, the second more advanced and human-specific 3,4 . Research on the shared affective representations of empathy has typically been conducted by investigating empathy to vicarious physical pain 1-3 . Empathy for pain, a capacity sculpted by the long history of mammalian evolution, enhance species survival by increasing brain sensitivity to the pain of kin and affiliates and expanding threat-detection to the level of the group thereby motivating care for conspecifics 5,6 . Yet, while rudimentary empathy for pain is associated with sensory processing and observed in rodents 7 and primates 8 , it also extends to include higher-order affective representations in addition to sensorimotor activations 9 , efficiently differentiates self from other 10 , expands from kin to humankind, and integrates sensory-motor resonance with cognitive understanding of others' needs and emotions 11 . However, despite extant research on empathy for pain and its neural correlates [1][2][3]10,12 , it is unclear whether the mature form of human empathy for pain is inborn or develops over time and what neural processes underpin its maturation.Developmental studies indicate that rudimentary empathy is observed already in newborns, expressed as resonance to another infant's cry 13 , and develops across childhood and adolescence, reaching maturity in adulthood 14 . Neuroimaging studies report that this early empathy relies on sensory and rudimentary networks, which are mostly in place by the end of infancy, whereas mature empathy recruits frontal areas that reach maturity by late adolescence or young adulthood 15,16 . Singer and colleagues 17 showed that mature human empathy ...
