Neuroimaging studies of alexithymia: physical, affective, and social perspectives

Abstract

Alexithymia refers to difficulty in identifying and expressing one’s emotions, and it is related to disturbed emotional regulation. It was originally proposed as a personality trait that plays a central role in psychosomatic diseases. This review of neuroimaging studies on alexithymia suggests that alexithymia is associated with reduced neural responses to emotional stimuli from the external environment, as well as with reduced activity during imagery, in the limbic and paralimbic areas (i.e., amygdala, insula, anterior/posterior cingulate cortex). In contrast, alexithymia is also known to be associated with enhanced neural activity in somatosensory and sensorimotor regions, including the insula. Moreover, neural activity in the medial, prefrontal, and insula cortex was lowered when people with alexithymia were involved in social tasks. Because most neuroimaging studies have been based on sampling by self-reported questionnaires, the contrasted features of neural activities in response to internal and external emotional stimuli need to be elucidated. The social and emotional responses of people with alexithymia are discussed and recommendations for future research are presented.

Alexithymic features and the labeling of brief emotional facial expressions – An fMRI study

“…However, this mechanism of overamplifying sensorimotor and motor aspects of the facial expression (cf. Moriguchi and Komaki, 2013) apparently does not work when the faces are presented for a very short time leading to a decline in performance of high alexithymic individuals.…”

“…Moreover, alexithymic features correlated with increased activation in brain areas related to somatosensory and motor processing during the labeling of facial emotions. This indicates that alexithymic individuals rely on information related to the bodily configuration of the facial expression rather than affective cues when inferring others' emotions , see also Laricchiuta et al, in press;Moriguchi and Komaki, 2013). This mechanism presumably enables alexithymic individuals to correctly label facial expressions presented with little temporal constraints.…”

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

“…Although we believe there were important clinical implications in our study, many issues have yet to be clarified. Recent advances in brain imaging have revealed the uniqueness of alexithymia in the neural response to internal and external stimuli (49), suggesting its possibility in utilizing a biopsychosocial approach in clinical practice (10). Second, the results of this study were based on data measured at a single time point; therefore, we could not assess the direction of the association, and any measurement error may have influenced the findings.…”

Measurement equivalence of the Toronto Structured Interview for Alexithymia across language, gender, and clinical status

“…Over the past two decades there has been a rapid expansion of empirical research on the alexithymia construct including brain imaging studies, genetic studies, attachment studies, explorations of associations between alexithymia and various psychiatric and medical disorders, and investigations of the influence of alexithymia on treatment outcomes (for recent reviews see Taylor and Bagby, 2012;Luminet et al, 2013;Moriguchi and Komaki, 2013;Taylor and Bagby, 2013). Most of this research has used the selfreport 20-item Toronto Alexithymia Scale (Bagby et al, 1994a;Bagby et al, 1994b) to measure alexithymia.…”