Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T21:28:04.708Z Has data issue: false hasContentIssue false

Neuropsychological correlates of alexithymia in Parkinson's disease

Published online by Cambridge University Press:  18 October 2007

ALBERTO COSTA
Affiliation:
Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Roma, Italy
ANTONELLA PEPPE
Affiliation:
Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Roma, Italy
GIOVANNI AUGUSTO CARLESIMO
Affiliation:
Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Roma, Italy Clinica Neurologica, Università di Roma “Tor Vergata,” Roma, Italy
GIOVANNA SALAMONE
Affiliation:
Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Roma, Italy
CARLO CALTAGIRONE
Affiliation:
Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Roma, Italy Clinica Neurologica, Università di Roma “Tor Vergata,” Roma, Italy

Abstract

There are recent reports that alexithymia may be associated with brain dysfunction involving frontal lobes or right hemisphere regions. However, little is known about the relationship between alexithymia and cognitive deficits in Parkinson's disease (PD). The authors investigated the neuropsychological correlates of alexithymia in a population of 70 nondemented PD patients and 70 controls. Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale (TAS-20). Standardized scales that measure verbal episodic memory, executive functions, abstract reasoning, and visual–spatial and language abilities were adopted. PD patients with alexithymia performed worse than both PD patients without alexithymia and controls with or without alexithymia on tasks requiring visual–spatial processing. Moreover, regression analyses showed that, in PD patients, but not in controls, poor performance on a constructional praxis task predicted high scores on the TAS-20 subscale, which assesses difficulty in identifying emotions. These data evidence an association between alexithymia and visual–spatial processing alterations in PD patients, supporting the view that the right hemisphere could be specifically involved in the modulation of some facets of alexithymia. (JINS, 2007, 13, 980–992.)

Type
Research Article
Copyright
© 2007 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adolphs, R., Damasio, H., Tranel, D., & Damasio, A.R. (1996). Cortical systems for the recognition of emotion in facial expression. Journal of Neuroscience, 16, 76787687.Google Scholar
Aftanas, L.I. & Varlamov, A.A. (2004). Association of alexithymia with anterior and posterior activation asymmetries during evoked emotions: EEG evidence of right hemisphere “electrocortical effort”. International Journal of Neuroscience, 114, 14431462.Google Scholar
Aftanas, L.I. & Varlamov, A.A. (2007). Effects of alexithymia on the activity of the anterior and posterior areas of the cortex of the right hemisphere in positive and negative emotional activation. Neuroscience and Behavioural Physiology, 37, 6773.Google Scholar
Alhaj, H.A., Massey, A.E., & McAllister-Williams, R.H. (2007). A study of the neural correlates of episodic memory and HPA axis status in drug-free depressed patients and healthy controls. Journal of Psychiatric Research, 41, 295304.CrossRefGoogle Scholar
Anderson, A.K. & Phelps, E.A. (2001). Lesions of the human amygdala impair enhanced perception of emotionally salient events. Nature, 411, 305309.CrossRefGoogle Scholar
Arrigoni, G. & De Renzi, E. (1964). Constructional apraxia and hemispheric locus of lesion. Cortex, 1, 170197.Google Scholar
Bagby, R.M., Parker, J.D.A., & Taylor, G.J. (1994a). The Twenty-Item Toronto Alexithymia Scale I: Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 2332.Google Scholar
Bagby, R.M., Parker, J.D.A., & Taylor, G.J. (1994b). The Twenty-Item Toronto Alexithymia Scale II: Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 3340.Google Scholar
Beck, A.T. & Steer, R.A. (1987). Beck Depression Inventory Manual. San Antonio: Psychological Corporation.
Berthoz, S., Artiges, E., Van de Moortele, P.F., Poline, J.B., Rouquette, S., Consoli, S.M., & Martinot, J.L. (2002). Effect of impaired recognition and expression of emotions on frontocingulate cortices: An fMRI study of men with alexithymia. The American Journal of Psychiatry, 159, 961967.Google Scholar
Binder, L.M. (1982). Constructional strategies on complex figure drawings after unilateral brain damage. Journal of Clinical Neuropsychology, 4, 5158.Google Scholar
Borkowsky, J.G., Benton, A.L., & Spreen, O. (1967). Word fluency and brain damage. Neuropsychologia, 5, 135140.Google Scholar
Borod, J.C., Rorie, K.D., Haywood, C.S., Andelman, F., Obler, L.K., Welkowitz, J., Bloom, R.L., & Tweedy, J.R. (1996). Hemispheric specialization for discourse reports of emotional experiences: Relationship to demographic, neurological, and perceptual variables. Neuropsychologia, 34, 351359.Google Scholar
Burn, D.J. (2002). Depression in Parkinson's disease. European Journal of Neurology, 9 (Suppl. 3), 4454.Google Scholar
Caltagirone, C., Zoccolotti, P., Originale, G., Daniele, A., & Mammuccari, A. (1989). Autonomic reactivity and facial expression of emotions in brain damaged patients. In G. Gainotti & C. Caltagirone (Eds.), Emotion and the Dual Brain (pp. 204221). New York: Springer Verlag.
Carlesimo, G.A., Caltagirone, C., Gainotti, G., & the Group for the Standardization of the Mental Deterioration Battery. (1996). The Mental Deterioration Battery: Normative data, diagnostic reliability and qualitative analyses of cognitive impairment. European Neurology, 36, 378384.Google Scholar
Cools, R. (2006). Dopaminergic modulation of cognitive function-implications for L-dopa treatment in Parkinson's disease. Neuroscience and Biobehavioural Reviews, 30, 123.Google Scholar
Cooper, J.A., Sagar, H.J., Jordan, N., Harvey, N.S., & Sullivan, E.V. (1991). Cognitive impairment in early, untreated Parkinson's disease and its relationship to motor disability. Brain, 114, 20952122.Google Scholar
Costa, A., Peppe, A., Carlesimo, G.A., Pasqualetti, P., & Caltagirone, C. (2006). Alexithymia in Parkinson's disease is related to severity of depressive symptoms. European Journal of Neurology, 13, 836841.CrossRefGoogle Scholar
Costa, A., Peppe, A., Carlesimo, G.A., Salamone, G., & Caltagirone, C. Prevalence and characteristics of alexithymia in Parkinson's disease. Manuscript submitted for publication.
Costa, A., Peppe, A., Dell'Agnello, G., Carlesimo, G.A., Murri, L., Bonuccelli, U., & Caltagirone, C. (2003). Dopaminergic modulation of visual-spatial working memory in Parkinson's disease. Dementia and Geriatric Cognitive Disorders, 15, 5566.Google Scholar
Crucian, G.P. & Okun, M.S. (2003). Visual-spatial ability in Parkinson's disease. Frontiers in Bioscience, 8(Suppl), 992997.Google Scholar
Dubois, B. & Pillon, B. (1997). Cognitive deficits in Parkinson's disease. Journal of Neurology, 244, 28.Google Scholar
Endler, N.S., Rutherford, A., & Denisoff, E. (1999). Beck Depression Inventory: Exploring its dimensionality in a nonclinical population. Journal of Clinical Psychology, 55, 13071312.Google Scholar
Fahn, S., Elton, R.L., & members of the UPDRS Committee. (1987). Unified Parkinson's Disease Rating Scale. In S. Fahn, P.D. Marsden, D.B. Calne, & A. Liebarman (Eds.), Recent Development in Parkinson's Disease (pp. 153163). Florman Park, NJ: Macmillan Health Care Information.
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Gainotti, G., Miceli, G., & Caltagirone, C. (1977). Constructional apraxia in left brain damaged patients: A planning disorder? Cortex, 13, 109118.Google Scholar
Green, J., McDonald, W.M., Vitek, J.L., Evatt, M., Freeman, A., Haber, M., Bakay, R.A.E., Triche, S., Sirockman, B., & DeLong, M.R. (2002). Cognitive impairments in advanced PD without dementia. Neurology, 59, 13201324.CrossRefGoogle Scholar
Gundel, H., López-Sala, A., Ceballos-Baumann, A.O., Deus, J., Cardoner, N., Marten-Mittag, B., Soriano-Mas, C., & Pujol, J. (2004). Alexithymia correlates with the size of the right anterior cingulate. Psychosomatic Medicine, 66, 132140.Google Scholar
Hamsher, K.D., Capruso, D.X., & Benton, A. (1992). Visuospatial judgment and right hemisphere disease. Cortex, 28, 493495.Google Scholar
Haxby, J.V., Grady, C.L., Hoewitz, B., Salerno, J., Ungerleider, L.G., Minshkin, M., & Shapiro, M.B. (1993). Dissociation of object and spatial visual processing pathways in human extrastriate cortex. In B. Gulyás, D. Ottoson, & P.E. Roland (Eds.), Functional Organization of Human Visual Cortex (pp. 329340). Oxford: Pergamon Press.
Henry, J.D., Phillips, L.H., Crawford, J.R., Theodorou, G., & Summers, F. (2006). Cognitive and psychosocial correlates of alexithymia following traumatic brain injury. Neuropsychologia, 44, 6272.CrossRefGoogle Scholar
Honkalampi, K., Hintikka, J., Tanskanen, A., Lehtonen, J., & Viinamäki, H. (2000). Depression is strongly associated with alexithymia in the general population. Journal of Psychosomatic Research, 48, 99104.CrossRefGoogle Scholar
Hornak, J., Rolls, E.T., & Wade, D. (1996). Face and voice expression identification in patients with emotional and behavioural changes following ventral frontal lobe damage. Neuropsychologia, 34, 247261.Google Scholar
Huber, S.J., Freidenberg, D.L., Shuttleworth, E.C., Paulson, G.W., & Clapp, L.E. (1989). Neuropsychological similarities in lateralized parkinsonism. Cortex, 25, 461470.CrossRefGoogle Scholar
Jacobs, D.H., Shuren, J., Bowers, D., & Heilman, K.M. (1995). Emotional facial imagery, perception, and expression in Parkinson's disease. Neurology, 45, 16961702.Google Scholar
Janvin, C., Aarsland, D., Larsen, J.P., & Hugdahl, K. (2003). Neuropsychological profile of patients with Parkinson's disease without dementia. Dementia and Geriatric Cognitive Disorders, 15, 126131.Google Scholar
Jessimer, M. & Markham, R. (1997). Alexithymia: A right hemisphere dysfunction specific to recognition of certain facial expressions? Brain and Cognition, 34, 246258.Google Scholar
Kano, M., Fukudo, S., Gyoba, J., Lamachi, M., Tagawa, M., Mochizuki, H., Itoh, M., Hongo, M., & Yanai, K. (2003). Specific brain processing of facial expressions in people with alexithymia: An H215O-PET study. Brain, 126, 14741484.Google Scholar
Larsen, J.K., Brand, N., Bermond, B., & Hijman, R. (2003). Cognitive and emotional characteristics of alexithymia. A review of neurobiological studies. Journal of Psychosomatic Research, 54, 533541.Google Scholar
Leentjens, A.F.G., Verhey, F.R.J., Luijckx, G., & Troost, J. (2000). The validity of the Beck Depression Inventory as a screening and diagnostic instrument for depression in patients with Parkinson's disease. Movement Disorders, 15, 12211224.Google Scholar
Lewis, S.J.G., Dove, A., Robbins, T.W., Barker, R.A., & Owen, A.M. (2003). Cognitive impairments in early Parkinson's disease are accompanied by reductions in activity in frontostriatal neural circuitry. The Journal of Neuroscience, 23, 63516356.Google Scholar
Makuuchi, M., Kaminaga, T., & Sugishita, M. (2003). Both parietal lobes are involved in drawing: A functional MRI study and implications for constructional apraxia. Cognitive Brain Research, 16, 338347.Google Scholar
Mandal, M.K., Borod, J.C., Asthana, H.S., Mohanty, A., Mohanty, S., & Koff, E. (1999). Effects of lesion variables and emotion type on the perception of facial emotion. The Journal of Nervous and Mental Risease, 187, 603609.Google Scholar
Miller, E.N., Fujioka, T.A., Chapman, L.J., & Chapman, J.P. (1995). Hemispheric asymmetries of function in patients with major affective disorders. Journal of Psychiatric Research, 29, 173183.Google Scholar
Milner, B. (1963). Effects of different brain lesions on card sorting. Archives of Neurology, 9, 100110.Google Scholar
Min, S.K. & Oh, B.H. (1992). Hemispheric asymmetry in visual recognition of words and motor responses in schizophrenic and depressive patients. Biological Psychiatry, 31, 255262.Google Scholar
Muslimovic, D., Post, B., Speelman, J.D., & Schmand, B. (2005). Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology, 65, 12391245.Google Scholar
Nelson, H.E. (1976). A modified card sorting test sensitive to frontal lobe defects. Cortex, 12, 313324.CrossRefGoogle Scholar
Nichelli, P. (1996). I disturbi spaziali e visuo-immaginativi. In G. Denes & L. Pizzamiglio (Eds.), Manuale di neuropsicologia (pp. 609638). Bologna: Zanichelli.
Nocentini, U., Di Vincenzo, S., Panella, M., Pasqualetti, P., & Caltagirone, C. (2002). La valutazione delle funzioni esecutive nella pratica neuropsicologica: Dal Modified Card Sorting Test al Modified Card Sorting Test–Roma Version. Dati di standardizzazione. Nuova Rivista di Neurologia, 12, 1424.Google Scholar
Oldfield, R.C. (1971). The assessment and analysis of handedness: The Edinburgh Inventory. Neuropsychologia, 9, 97113.Google Scholar
Ouchi, Y., Yoshikawa, E., Okada, H., Futatsubashi, M., Sekine, Y., Iyo, M., & Sakamoto, M. (1999). Alterations in binding site density of dopamine transporter in the striatum, orbitofrontal cortex, and amygdala in early Parkinson's disease: Compartment analysis for beta-CFT binding with positron emission tomography. Annals of Neurology, 45, 601610.Google Scholar
Owen, A.M. (2004). Cognitive dysfunction in Parkinson's disease: The role of frontostriatal circuitry. The Neuroscientist, 10, 527537.Google Scholar
Parker, J.D.A., Bagby, R.M., & Taylor, G.J. (1991). Alexithymia and depression: Distinct or overlapping constructs? Comprehensive Psychiatry, 32, 387394.Google Scholar
Parker, J.D.A., Keightley, M.L., Smith, C.T., & Taylor, G.J. (1999). Interhemispheric transfer deficit in alexithymia: An experimental study. Psychosomatic Medicine, 61, 464468.Google Scholar
Parker, J.D.A., Taylor, G.J., & Bagby, R.M. (2003). The 20-item Toronto Alexithymia Scale–III. Reliability and factorial validity in a community population. Journal of Psychosomatic Research, 55, 269275.Google Scholar
Piercy, M., Hecaen, H., & Ajuriaguerra, J. (1960). Constructional apraxia associated with unilateral cerebral lesion: Left- and right-sided cases compared. Brain, 83, 225242.Google Scholar
Raven, J.C. (1947). Progressive Matrices. Sets A, Ab, B: Board and Book Forms. London: Lewis.
Rey, A. (1958). Memorisation d'une serie de 15 mots en 5 repetitions. In A. Rey (Ed.), L'examen clinique en psychologie. Paris: Presses Universitaires des France.
Ross, E.D. & Mesulam, M.M. (1979). Dominant language functions of the right hemisphere: Prosody and emotional gesturing. Archives of Neurology, 36, 144148.Google Scholar
Spalletta, G., Pasini, A., Costa, A., De Angelis, D., Ramundo, N., Paolucci, S., & Caltagirone, C. (2001). Alexithymic features in stroke: Effects of laterality and gender. Psychosomatic Medicine, 63, 944950.CrossRefGoogle Scholar
Spielberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
St. Clair, J., Borod, J.C., Sliwinski, M., Cote, L.J., & Stern, Y. (1998). Cognitive and affective functioning in Parkinson's disease patients with lateralized motor signs. Journal of Clinical and Experimental Neuropsychology, 20, 320327.CrossRefGoogle Scholar
Taylor, G.J., Bagby, R.M., & Parker, J.D.A. (1991). The alexithymia construct: A potential paradigm for psychosomatic medicine. Psychosomatics, 32, 153164.Google Scholar
Tessitore, A., Hariri, A.R., Fera, F., Smith, W.G., Chase, T.N., Hyde, T.M., Weinberger, D.R., & Mattay, V.S. (2002). Dopamine modulates the response of the human amygdala: A study in Parkinson's disease. The Journal of Neuroscience, 22, 90999103.Google Scholar
Troisi, E., Peppe, A., Pierantozzi, M., Matteis, M., Vernieri, F., Stanzione, P., Silvestrini, M., & Caltagirone, C. (2002). Emotional processing in Parkinson's disease. A study using functional transcranial Doppler sonography. Journal of Neurology, 249, 9931000.Google Scholar
Trojano, L., Fragassi, N.A., Chiacchio, L., Izzo, O., Izzo, G., Di Cesare, G., Cristinzio, C., & Grossi, D. (2004). Relationship between constructional and visuospatial abilities in normal subjects and in focal brain-damaged patients. Journal of Clinical and Experimental Neuropsychology, 26, 11031112.CrossRefGoogle Scholar
Visser, M., Leetjens, A.F., Marinus, J., Stiggelbout, A.M., van Hilten, J.J. (2006). Reliability and validity of the Beck depression inventory in patients with Parkinson's disease. Movement Disorders, 21, 668672.CrossRefGoogle Scholar
Warrington, E.K. & Rabin, P. (1970). Perceptual matching in patients with cerebral lesions. Neuropsychologia, 8, 175187.CrossRefGoogle Scholar
Weintraub, D., Moberg, P.J., Culberston, W.C., Duda, J.E., Katz, I.R., & Stern, M.B. (2005). Dimensions of executive function in Parkinson's disease. Dementia and Geriatric Cognitive Disorders, 20, 140144.Google Scholar
Wirsen, A., Klinteberg, B., Levander, S., & Schalling, D. (1990). Differences in asymmetric perception of facial expression in free-vision chimeric stimuli and reaction time. Brain & Cognition, 12, 229239.Google Scholar
Wise, T.N., Mann, L.S., Hryvniak, M., Mitchell, J.D., & Hill, B. (1990). The relationship between alexithymia and abnormal illness behaviour. Psychotherapy and Psychosomatics, 54, 1825.Google Scholar