The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate

Jutta Ernst, Heinz Böker, Joe Hättenschwiler, Daniel Schüpbach, Georg Northoff, Erich Seifritz, Simone Grimm

Research output: Contribution to journalArticlepeer-review

79 Citations (Scopus)


Alexithymia and increased interoceptive awareness have been associated with affective disorders as well as with altered insula and anterior cingulate cortex (ACC) function. Brain imaging studies have demonstrated an association between neurotransmitter function and affective disorders as well as personality traits. Here, we first examined the relationship between alexithymic facets as assessed with the Toronto Alexithymia Scale (TAS-20) and interoceptive awareness (assessed with the Body Perception Questionnaire) in 18 healthy subjects. Second, we investigated their association with glutamate and gamma-aminobutyric acid (GABA) concentrations in the left insula and the ACC using 3-Tesla proton magnetic resonance spectroscopy. Behaviorally, we found a close association between alexithymia and interoceptive awareness. Furthermore, glutamate levels in the left insula were positively associated with both alexithymia and awareness of autonomic nervous system reactivity, while GABA concentrations in ACC were selectively associated with alexithymia. Although preliminary, our results suggest that increased glutamate-mediated excitatory transmission-related to enhanced insula activity-reflects increased interoceptive awareness in alexithymia. Suppression of the unspecific emotional arousal evoked by increased awareness of bodily responses in alexithymics might thus be reflected in decreased neuronal activity mediated by increased GABA concentration in ACC.

Original languageEnglish
Article numbernst058
Pages (from-to)857-863
Number of pages7
JournalSocial Cognitive and Affective Neuroscience
Issue number6
Publication statusPublished - 2013
Externally publishedYes


  • Alexithymia
  • Interoceptive awareness
  • Neurotransmitter
  • Proton magnetic resonance spectroscopy

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Experimental and Cognitive Psychology
  • Medicine(all)


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