Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism

It is widely accepted that autism is associated with disordered emotion processing, and in particular, with deficits of emotional reciprocity such as impaired emotion recognition and reduced empathy. However, a close examination of the literature reveals wide heterogeneity within the autistic population with respect to emotional competence. Here we argue that, where observed, emotional impairments are due to alexithymia - a condition that frequently co-occurs with autism - rather than a feature of autism per se. Alexithymia is a condition characterized by a reduced ability to identify and describe one’s own emotion, but which results in reduced empathy and an impaired ability to recognize the emotions of others. We briefly review studies of emotion processing in alexithymia, and in autism, before describing a recent series of studies directly testing this ‘alexithymia hypothesis’. If found to be correct, the alexithymia hypothesis has wide-reaching implications for the study of autism, and how we might best support sub-groups of autistic individuals with, and without, accompanying alexithymia. Finally, we note the presence of elevated rates of alexithymia, and inconsistent reports of emotional impairments, in eating disorders, schizophrenia, substance abuse, Parkinson’s Disease, Multiple Sclerosis, and anxiety disorders. We speculate that examining the contribution of alexithymia to the emotional symptoms of these disorders may bear fruit in the same way that it is starting to do in autism

Left hemisphere dominance in reading the sensory qualities of others\u2019 pain?

Seeing or imagining others in pain may activate both the sensory and affective components of the neural network (pain matrix) that is activated during the personal experience of pain. Transcranial magnetic stimulation (TMS), proved adept to highlight the sensorimotor side of empathy for pain in studies where mere observation of needles penetrating body parts of a human model brought about a clear corticospinal motor inhibition. By using TMS, we investigated whether inferring the sensory properties of the pain of a model influenced the somatomotor system of an onlooker. Moreover, we tested the possible lateralization of the motor substrates underlying this reading process. We recorded motor-evoked potentials (MEPs) to left and right motor cortex stimulation during the observation of \u2018flesh and bone\u2019 painful stimulations of right and left hand respectively. We found a significant reduction of onlookers\u2019 MEPs amplitudes specific to the muscle penetrated in the model. Subjective inferences about localization and intensity of the observed pain were associated with specific patterns of motor modulation with larger inhibitory effects following stimulation of the left motor cortex. Thus, results indicate that the mental simulation of the sensory qualities of others\u2019 pain may be lateralized to the left hemispher

The pain of a model in the personality of an onlooker: influence of state-reactivity and personality traits on embodied empathy for pain

The study of inter-individual differences at behavioural and neural levels represents a new avenue for neuroscience. The response to socio-emotional stimuli varies greatly across individuals. For example, identification with the feelings of a movie character may be total for some people or virtually absent for others. Inter-individual differences may reflect both the on-line effect (state) of the observed stimuli and more stable personal characteristics (trait). Here we show that somatomotor mirror responses when viewing others\u2019 pain are modulated by both state- and trait-differences in empathy. We recorded motor-evoked potentials (MEPs) induced by Transcranial Magnetic Stimulation (TMS) in healthy individuals observing needles penetrating a model\u2019s hand. We found a reduction of corticospinal excitability that was specific for the muscle that subjects observed being penetrated. This inhibition correlated with sensory qualities of the pain ascribed to the model. Moreover, it was greater in subjects with high trait-cognitive empathy and lower in subjects with high trait-personal distress and in those with high aversion for the observed movies. Results indicate that somatomotor responses to others\u2019 pain are influenced by specific onlookers\u2019 personality traits and self-oriented emotional reactions. Our findings suggest that multiple distinct mechanisms shape mirror mapping of others\u2019 pain

Stimulus-driven modulation of motor-evoked potentials during observation of others' pain

Empathy may allow interindividual sharing not only of emotions (e.g., joy, sadness, disgust) but also of sensations (e.g., touch, itching, pain). Although empathy for pain may rely upon both sensory and affective components of the pain experience, neuroimaging studies indicate that only the affective component of the pain matrix is involved in empathy for pain. By using transcranial magnetic stimulation (TMS), we highlighted the sensorimotor side of empathy for pain by showing a clear motor inhibition during the mere observation of needles penetrating body parts of a human model. Here, we explored stimulus-specific and instruction-specific influences on this inhibition by manipulating task instructions (request to adopt first- or third-person perspective vs. passive observation) and painfulness of the experimental stimuli (presentation of videos of needles deeply penetrating or simply pinpricking a hand). We found a significant reduction in amplitudes of motor-evoked potentials (MEPs) specific to the muscle the subjects observed being penetrated that correlated with the intensity of the pain attributed to the model. Crucially, this motor inhibition was present during observation of penetrating but not of pinpricking needles. Moreover, no MEPs modulation contingent upon different task instructions was found. Results suggest that the motor inhibition elicited by the observation of "flesh and bone" pain stimuli is more stimulus-driven than instruction-drive