Alexithymia is related to differences in gray matter volume: A voxel-based morphometry study

Abstract Objective : Alexithymia has been characterized as the inability to identify and describe feelings. Functional imaging studies have revealed that alexithymia is linked to reactivity changes in emotion- and face-processing-relevant brain areas. In this respect, anterior cingulate cortex (ACC), amygdala, anterior insula and fusiform gyrus (FFG) have been consistently reported. However, it remains to be clarified whether alexithymia is also associated with structural differences. Methods : Voxel-based morphometry on T1-weighted magnetic resonance images was used to investigate gray matter volume in 17 high alexithymics (HA) and 17 gender-matched low alexithymics (LA), which were selected from a sample of 161 healthy volunteers on basis of the 20-item Toronto Alexithymia Scale. Data were analyzed as statistic parametric maps for the comparisons LA>HA and HA>LA in a priori determined regions of interests (ROIs), i.e., ACC, amygdala, anterior insula and FFG. Moreover, an exploratory whole brain analysis was accomplished. Results : For the contrast LA>HA, significant clusters were detected in the ACC, left amygdala and left anterior insula. Additionally, the whole brain analysis revealed volume differences in the left middle temporal gyrus. No significant differences were found for the comparison HA>LA. Conclusion : Our findings suggest that high compared to low alexithymics show less gray matter volume in several emotion-relevant brain areas. These structural differences might contribute to the functional alterations found in previous imaging studies in alexithymia.