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The neurocognition of alexithymia: evidence from neuropsychological and neuroimaging studies

Published online by Cambridge University Press:  24 June 2014

Ellen Wingbermühle*
Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University Nijmegen, Nijmegen, The Netherlands
Hanneke Theunissen
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
Willem M. A. Verhoeven
Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands
Roy P. C. Kessels
Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University Nijmegen, Nijmegen, The Netherlands Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Jos I. M. Egger
Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University Nijmegen, Nijmegen, The Netherlands Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands Pompe Institute for Forensic Psychiatry, Pro Persona, Nijmegen, The Netherlands
Ellen Wingbermühle, Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Stationsweg 46, 5803 AC Venray, The Netherlands. Tel: +31-478-527-339; Fax: +31-478-527-626; E-mail:


Objective: Alexithymia refers to an ineffective regulation and expression of emotions. It constitutes a major risk factor for a range of medical and psychiatric problems, including chronic pain, somatisation, anxiety and depression. Alexithymia is a multi-faceted concept, described in terms of cognitive and affective aspects. From a neuropsychological perspective, alexithymia can be defined as a disturbance in affective information processing and social cognition. As the growing literature on brain structures involved in alexithymia is fragmented and sometimes even contradictory, the aim of this article was to review findings on neural substrates with regard to their convergence.

Methods: A narrative review was performed, including both early neuropsychological and more recent imaging studies, in order to achieve a better understanding of the aetiology of alexithymia.

Results: Corpus callosum, cingulate cortex and insula are clearly involved in alexithymia. The amygdala and the orbitofrontal part of the cortex appear to be implicated as mediators, because of their broader involvement in emotional processing and executive control.

Conclusion: Notwithstanding the diffuse neural representation, the alexithymia construct can be usefully applied in the clinical and empirical studies of social cognition, particularly when adopting a dimensional neuropsychological approach.

Review Article
Copyright © Cambridge University Press 2011

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