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Neuropsychologia. 2018 Mar;111:229-240. doi: 10.1016/j.neuropsychologia.2017.12.037. Epub 2018 Jan 31.

Language and alexithymia: Evidence for the role of the inferior frontal gyrus in acquired alexithymia.

Author information

1
Department of Psychology, Social Work and Counselling, University of Greenwich, Avery Hill Road, Eltham, London SE9 2UG, UK. Electronic address: h.hobson@greenwich.ac.uk.
2
University of California Davis, M.I.N.D. Institute, 2825 50th St, Sacramento, CA 95817, USA.
3
Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham TW20 0EX, UK.
4
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK.
5
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Cognitive Science Department, Johns Hopkins University, Baltimore, MD, USA.
6
Molecular Neuroscience Department, George Mason University, Fairfax, VA, USA; Department of Psychology, George Mason University, Fairfax, VA, USA.
7
Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA.
8
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK; Department of Experimental Psychology, University of Oxford, 5 Parks Rd, Oxford OX1 3PH, UK.
9
Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Neurology, Feinberg School of Medicine, Northwestern University, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Abstract

The clinical relevance of alexithymia, a condition associated with difficulties identifying and describing one's own emotion, is becoming ever more apparent. Increased rates of alexithymia are observed in multiple psychiatric conditions, and also in neurological conditions resulting from both organic and traumatic brain injury. The presence of alexithymia in these conditions predicts poorer regulation of one's emotions, decreased treatment response, and increased burden on carers. While clinically important, the aetiology of alexithymia is still a matter of debate, with several authors arguing for multiple 'routes' to impaired understanding of one's own emotions, which may or may not result in distinct subtypes of alexithymia. While previous studies support the role of impaired interoception (perceiving bodily states) in the development of alexithymia, the current study assessed whether acquired language impairment following traumatic brain injury, and damage to language regions, may also be associated with an increased risk of alexithymia. Within a sample of 129 participants with penetrating brain injury and 33 healthy controls, neuropsychological testing revealed that deficits in a non-emotional language task, object naming, were associated with alexithymia, specifically with difficulty identifying one's own emotions. Both region-of-interest and whole-brain lesion analyses revealed that damage to language regions in the inferior frontal gyrus was associated with the presence of both this language impairment and alexithymia. These results are consistent with a framework for acquired alexithymia that incorporates both interoceptive and language processes, and support the idea that brain injury may result in alexithymia via impairment in any one of a number of more basic processes.

KEYWORDS:

Alexithymia; Anterior insula; Inferior frontal gyrus; Language; Traumatic brain injury

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