Depression

How does brain activity during body awareness relate to alexithymia?

Wiebking C, Northoff G · Frontiers in psychology · 2015

Open access · cc by · source: Europe PMC

Healthy people with difficulty describing emotions show altered brain activity during body-awareness tasks, a pattern that is disrupted in individuals with major depression.

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How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

SupportsInteroceptionconcept
Healthy individuals with high alexithymia exhibit altered neural processing in the insula and anterior cingulate cortex during interoceptive attention, a pattern that is notably disrupted in patients with major depressive disorder.
Evidence for the claim as stated.
SupportsAlexithymiaconcept
In healthy individuals, alexithymia is linked to altered brain activity during interoceptive body-awareness tasks, but this typical neural pattern is absent in individuals with major depressive disorder.
Evidence for the claim as stated.

Study at a glance

Design: Case-control — fMRI heartbeat-counting (interoceptive awareness) plus TAS-20 in MDD vs non-psychiatric controls split by alexithymia
N: N=46 · 30 non-psychiatric controls and 16 MDD patients who completed both TAS and scanning
Population: Patients with major depressive disorder and non-psychiatric controls
Outcome: Insula and related fMRI activity during heartbeat counting, associated with TAS alexithymia

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How does brain activity during body awareness relate to alexithymia?

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30 healthy control participants

Hence, 30 NC (mean age 33.73 ± 11.62 years, range 22–60 years; mean years of education: 16.05 ± 2.42; 15 female participants) and 16 MDD patients (mean age 41.19 ± 11.78 years, range 23–58 years; mean years of education: 15.72 ± 2.88; 11 female participants) completed both study parts and were included in further analysis.

9 to 13 seconds

Each condition was presented 48 times in total in a pseudo-randomized order for 9–13 s each.

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Key findings

Healthy controls with higher scores for difficulty describing feelings showed decreased activity in the supragenual anterior cingulate cortex during the body awareness task. When healthy participants were split into a high-alexithymia group of 14 and a low-alexithymia group of 16, the high-alexithymia group showed increased activity in the insula. However, the 16 depressed patients did not show this increased insula activity despite having similarly high difficulty describing feelings.

Methodology

The researchers scanned 30 healthy control participants and 16 patients with major depressive disorder using functional magnetic resonance imaging. During the scans, participants completed a task where they silently counted their own heartbeat for trials lasting 9 to 13 seconds, which was repeated 48 times per condition. Participants also filled out the 20-item Toronto Alexithymia Scale to measure their difficulty identifying and describing emotions.

Limitations

Because this is a correlational study using functional neuroimaging, it cannot establish whether changes in brain activity directly cause alexithymia or depressive symptoms. Additionally, all depressed patients were taking medication, which could confound the observed neural differences. Finally, the division of healthy controls into high and low categories was based on a small sample, which may not capture the true continuous nature of personality traits.

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