The ability to facially communicate physical distress (e.g. pain) can be essential to ensure help, support and clinical treatment for the individual experiencing physical distress. So far, it is not known to which degree this ability represents innate and biologically prepared programs or whether it requires visual learning. Here, we address this question by studying evoked and voluntary facial expressions of pain in congenitally blind (N=21) and sighted (N=42) individuals. The repertoire of evoked facial expressions was comparable in congenitally blind and sighted individuals; however, blind individuals were less capable of facially encoding different intensities of experimental pain. Moreover, blind individuals were less capable of voluntarily modulating their pain expression. We conclude that the repertoire of facial muscles being activated during pain is biologically prepared. However, visual learning is a prerequisite in order to encode different intensities of physical distress as well as for up- and down-regulation of one's facial expression.
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