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Impaired cognitive self-awareness mediates the association between alexithymia and excitation/inhibition balance in the pgACC

Published online by Cambridge University Press:  22 July 2019

A. Kühnel ,
A. Widmann ,
L. Colic ,
L. Herrmann ,
L. R. Demenescu ,
A. L. Leutritz ,
M. Li ,
S. Grimm ,
T. Nolte  and
P. Fonagy
...Show all authors
A. Kühnel
Affiliation:
Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
A. Widmann
Affiliation:
Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany Experimental and Molecular Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
L. Colic
Affiliation:
Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Leibniz Institute for Neurobiology, Magdeburg, Germany Department of Psychiatry, Mood Disorders Research Program, Yale School of Medicine, New Haven, CT, USA
L. Herrmann
Affiliation:
University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
L. R. Demenescu
Affiliation:
Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
A. L. Leutritz
Affiliation:
Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
M. Li
Affiliation:
University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany Department of Psychiatry and Psychotherapy, OVGU Magdeburg, Magdeburg, Germany
S. Grimm
Affiliation:
Department of Psychiatry, Charité, CBF, Berlin, Germany MSB Medical School Berlin, Calandrellistraße 1-9, 12247Berlin, Germany Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032Zurich, Switzerland
T. Nolte
Affiliation:
The Anna Freud National Centre for Children and Families, London, UK Wellcome Trust Centre for Neuroimaging, University College London, London, UK
P. Fonagy
Affiliation:
The Anna Freud National Centre for Children and Families, London, UK Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
M. Walter*
Affiliation:
Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany Leibniz Institute for Neurobiology, Magdeburg, Germany Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany Max Planck Institute for Biological Cybernetics, Tübingen, Germany
*
Author for correspondence: M. Walter, E-mail: martin.walter@uni-tuebingen.de
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Abstract

Background

Previous research showed that automatic emotion regulation is associated with activation of subcortical areas and subsequent feedforward processes to cortical areas. In contrast, cognitive awareness of emotions is mediated by negative feedback from cortical to subcortical areas. Pregenual anterior cingulate cortex (pgACC) is essential in the modulation of both affect and alexithymia. We considered the interplay between these two mechanisms in the pgACC and their relationship with alexithymia.

Method

In 68 healthy participants (30 women, age = 26.15 ± 4.22) we tested associations of emotion processing and alexithymia with excitation/inhibition (E/I) balance represented as glutamate (Glu)/GABA in the pgACC measured via magnetic resonance spectroscopy in 7 T.

Results

Alexithymia was positively correlated with the Glu/GABA ratio (N = 41, p = 0.0393). Further, cognitive self-awareness showed an association with Glu/GABA (N = 52, p = 0.003), which was driven by a correlation with GABA. In contrast, emotion regulation was only correlated with glutamate levels in the pgACC (N = 49, p = 0.008).

Conclusion

Our results corroborate the importance of the pgACC as a mediating region of alexithymia, reflected in an altered E/I balance. Furthermore, we could specify that this altered balance is linked to a GABA-related modulation of cognitive self-awareness of emotions.

Keywords

Alexithymiaanterior cingulate cortex (ACC)emotion regulationmagnetic resonance spectroscopy (MRS)
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 10 , July 2020 , pp. 1727 - 1735
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

Shared first authorship.

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