Structure of the alexithymic brain: A parametric coordinate-based meta-analysis

Xu, Pengfei; Opmeer, Esther M.; Tol, Marie-José van; Goerlich, Katharina S.; Alemán, André

doi:10.1016/j.neubiorev.2018.01.004

Cited by 50 publications

(43 citation statements)

References 57 publications

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“…There is some evidence of these abnormal cognitive affective responses on functional MRI, with an Autistic population having less activity in their limbic system compared to a control population, a region of the brain associated with emotional processing [15]. In terms of structural changes, it has been found that there is a reduction in size in the insula, amygdala, orbitofrontal cortex and striatum in those with Alexithymia [16]. It has also been shown that there is reduced activation in the insula, when patients with Alexithymia are involved in tasks which require theory of mind, which may explain some of the overlap with Autism [17].…”

Section: Discussionmentioning

confidence: 99%

Assessing Subjective Emotional Experience in a Non-Autistic Population

Mccaw¹,

Talari²

2019

SJCM

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Clinicians within the Leeds Autism Diagnostic Service (LADS) have found that many of our patients have difficulty answering questions pertaining to subjective emotional experience. It was felt by clinicians within the service that service users who were later diagnosed as neuro-typical also had difficulty answering questions related to their subjective emotional state. It was felt that by examining responses to the meaning of four common emotional states (relaxation, anger, anxiety and happiness) in a neuro-typical population, themes or common words or phrases could be elicited in the description of each emotion. These questions were similar in scope to those found within the Autism Diagnostic Observation Schedule, 2 nd Edition, which is used by LADS during diagnostic assessments. This would then allow clinicians a means of comparing a service user's responses with what could be expected from a neuro-typical population. We felt that other teams within our organization unconnected with the Autism Diagnostic Service, could serve as a useful neuro-typical population. An online survey link was therefore sent to different administration teams within Leeds and York Partnership Foundation Trust, which allowed participants to complete four questions, each one asking them to describe the subjective meaning of relaxation, anger, anxiety and happiness in turn. There were no specific inclusion or exclusion criteria for these survey participants. Each question provided an area where each survey participant could express this in up to a few sentences. Following this, the results were analysed for common descriptors and actions, associated in the responses for a particular emotion. When analysing the results, it was evident that actions and activities were more frequently used in responses by the survey participants in responses to questions related to relaxation, anger and happiness, however were less apparent in the responses to describe anxiety. It is hoped that these results will be able to guide clinicians in interpreting and scoring diagnostic screening tools for Autism by providing more knowledge about neuro-typical responses.

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Section: Discussionmentioning

confidence: 99%

Assessing Subjective Emotional Experience in a Non-Autistic Population

Mccaw¹,

Talari²

2019

SJCM

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“…However, in my eyes the existing evidence suggests that such a differentiation is indeed worthwhile, for researchers and clinicians alike. Meta-analyses of functional and structural imaging studies have identified the amygdala, the insula, the ACC, and regions of the prefrontal cortex (PFC) as key correlates of alexithymia in the brain (van der Velde et al, 2013; Xu et al, 2018). However, whether these correlates are linked to specific facets and dimensions of alexithymia could not be systematically investigated due to the scarcity of evidence.…”

Section: Neuroscientific Evidence For Different Facets and Dimensionsmentioning

confidence: 99%

The Multifaceted Nature of Alexithymia – A Neuroscientific Perspective

Goerlich

2018

Front. Psychol.

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Neuroscientific studies have mostly employed the 20-item Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994a) for the assessment of alexithymia, a self-report scale that assesses the alexithymia facets difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. These facets can be considered to capture difficulties in the cognitive processing of emotions associated with alexithymia. However, Nemiah and Sifneos’ original conceptualization of alexithymia included also an affective component, a lack of imaginative capacities, which cannot be assessed using the TAS-20. Aiming to capture the entire alexithymia construct, the Bermond–Vorst Alexithymia Questionnaire (BVAQ; Vorst and Bermond, 2001) was developed, a self-report scale which assesses two affective facets (difficulty fantasizing and difficulty emotionalizing) in addition to three cognitive facets. Based on these facets, an affective and a cognitive dimension of alexithymia can be distinguished. By now, several neuroscientific studies have investigated the neural signatures of the different facets and dimensions of alexithymia. Here, I provide an overview of the history of the alexithymia facets and dimensions and review findings provided by functional and structural magnetic resonance imaging (MRI) studies that differentiated between the alexithymia facets and/or its affective and cognitive dimensions. I then provide a synopsis of the current neuroscientific evidence for dissociable substrates of alexithymia facets and dimensions. Finally, the scientific value and clinical implications of these findings are discussed.

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“…[27][28][29] Previous studies comparing healthy individuals with high and low alexithymia scores showed lower grey matter volume in people with high alexithymia. 7 In contrast, studies investigating healthy individuals with lower alexithymia scores have found no association or a positive association between alexithymia and grey matter volume. [30][31][32][33] Our aim was to find brain structural correlates of alexithymia in lifetime MDD and brain structural correlates that were differentially associated with alexithymia in healthy controls and patients with MDD.…”

Section: Introductionmentioning

confidence: 98%

“…The anterior cingulate cortex (ACC) and the fusiform gyrus (FFG) have been repeatedly shown to be areas with functional and structural aberrations related to alexithymia, as indicated by a recent metaanalysis. 7,8 The ACC monitors emotional experiences, 9 which are disrupted in individuals with alexithymia. 10 The fusiform J Psychiatry Neurosci 2020;45(2) gyrus, with its fusiform face area, is responsible for the processing of faces, 11 and thus, for emotion recognition.…”

Section: Introductionmentioning

confidence: 99%

“…Although alexithymia and its neurobiological underpinnings have been thoroughly investigated in healthy individuals, 12 it remains unclear whether alexithymia is associated with specific brain structural alterations in patients with MDD and whether such alterations differ from those in healthy people. Alexithymia involves difficulties in emotion perception, and thus, relates to emotion regulation and social interaction; all 3 core processes are highly relevant to the development and course of MDD.…”

Section: Introductionmentioning

confidence: 99%

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Brain structural correlates of alexithymia in patients with major depressive disorder

Förster

Enneking

Dohm

et al. 2020

jpn

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Background: Alexithymia is a risk factor for major depressive disorder (MDD) and has been associated with diminished treatment response. Neuroimaging studies have revealed structural aberrations of the anterior cingulate cortex and the fusiform gyrus in healthy controls with high levels of alexithymia. The present study tried to corroborate and extend these results to patients with MDD compared with healthy controls. Methods: We investigated the relationship between alexithymia, depression and grey matter volume in 63 patients with MDD (mean age ± standard deviation = 42.43 yr ± 11.91; 33 female) and 46 healthy controls (45.35 yr ± 8.37; 22 female). We assessed alexithymia using the Toronto Alexithymia Scale. We conducted an alexithymia × group analysis of covariance; we used a region-of-interest approach, including the fusiform gyrus and anterior cingulate cortex, and conducted whole brain analysis using voxelbased morphometry. Results: Our analysis revealed a significant alexithymia × group interaction in the fusiform gyrus (left, p FWE = 0.031; right, p FWE = 0.010). Higher alexithymia scores were associated with decreased grey matter volume in patients with MDD (p FWE = 0.009), but with increased grey matter volume of the fusiform gyrus in healthy controls (p FWE = 0.044). We found no significant main effects in the region-of-interest analysis. Limitations: Owing to the naturalistic nature of our study, patients with MDD and healthy controls differed significantly in their alexithymia scores. Conclusion: Our results showed the fusiform gyrus as a correlate of alexithymia. We also found differences related to alexithymia between patients with MDD and healthy controls in the fusiform gyrus. Our study encourages research related to the transition from risk to MDD in people with alexithymia.

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Structure of the alexithymic brain: A parametric coordinate-based meta-analysis

Cited by 50 publications

References 57 publications

Assessing Subjective Emotional Experience in a Non-Autistic Population

Assessing Subjective Emotional Experience in a Non-Autistic Population

The Multifaceted Nature of Alexithymia – A Neuroscientific Perspective

Brain structural correlates of alexithymia in patients with major depressive disorder

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