Discrepancy between Subjective Sensation and Visceral Perception in the Insular Cortex in Alexithymia

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  • Kano Michiko
    Sukawa Clinic, Kirari Health Coop Department of Behavioral Medicine, Tohoku University Graduate School of Medicine

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  • アレキシサイミアにおける島皮質での内臓知覚と自覚的感覚の乖離
  • アレキシサイミア ニ オケル シマ ヒシツ デ ノ ナイゾウ チカク ト ジカクテキ カンカク ノ カイリ

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Abstract

<p>Interoception in alexithymia is of growing interest in the research for the pathogenesis of psychosomatic disorders and in understanding the fundamental processes of emotion-body interaction in human. Empirical studies have shown inconsistent results, which were increased or decreased interoception in alexithymia, due to differences in the quality of the interoception targeted and the methodological differences of the investigations. Individuals with alexithymia demonstrated less accuracy in the heartbeat detection task. The visceral threshold in colonic distention was higher in the irritable bowel syndrome patients with alexithymia. These may indicate that alexithymia may decrease interoceptive ability to detect signals from the internal body. On the other hand, subjective assessment of bodily sensation and bodily symptoms such as with questionnaires exhibited hypersensitivity in healthy people and psychosomatic patients with alexithymia. Subjective belief in the internal bodily state may be amplified in alexithymia. Colonic distention and injection of corticotropin-releasing hormone induced excessive neuroendocrine response in alexithymia. During colonic distention, stronger brain activities in the insula, which is the visceral sensory cortex, was observed associated with higher alexithymia. This suggests the altered interoception and physiological reaction and their functional interaction may be dysregulated in alexithymia.</p>

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