Differente Muster regionaler Hirnaktivität nach emotionaler Stimulation bei alexithymen Patienten im Vergleich zu Normalpersonen

Michael Huber; Karl Herholz; Birgit Habedank; Alexander Thiel; Markus Müller-Küppers; Hermann Ebel; Claudia Subič-Wrana; Karl Köhle; Wolf-Dieter Heiss

doi:10.1055/s-2002-35276

PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, Table of Contents

Psychother Psychosom Med Psychol 2002; 52(11): 469-478
DOI: 10.1055/s-2002-35276

Originalarbeit

Differente Muster regionaler Hirnaktivität nach emotionaler Stimulation bei alexithymen Patienten im Vergleich zu Normalpersonen

Eine positronenemissionstomographische (PET-)Studie mit ¹⁵O-H₂O und emotionaler Stimulierung durch autobiografische ErinnerungDifferent Patterns of Regional Brain Activation During Emotional Stimulation in Alexithymics in Comparison with Normal ControlsA Positron Emission Tomography (PET) Study with ¹⁵O-H₂O and Emotional Stimulation by Way of Autobiographic RecallMichael Huber¹ , Karl Herholz² , Birgit Habedank¹ , Alexander Thiel² , Markus Müller-Küppers³ , Hermann Ebel³ , Claudia Subič-Wrana¹ , Karl Köhle¹ , Wolf-Dieter Heiss²

¹Institut und Poliklinik für Psychosomatik und Psychotherapie der Universität zu Köln
²Max-Planck-Institut für Neurologische Forschung, Köln
³Psychiatrische Universitätsklinik der RWTH Aachen

Abstract

Zusammenfassung

Unter Verwendung von ¹⁵O-H₂O-Positronenemissionstomographie und einem autobiografischen emotionalen Stimulationsparadigma wurden 9 Patienten mit somatoformen Störungen ohne sonstige Achse-I- oder Achse-II-Störung nach dem DSM-IV und hohen TAS-20-Werten (Toronto-Alexithymie-Skala) mit 10 Normalpersonen verglichen. Unter Stimulationsbedingungen (Trauer, Freude) zeigten Normalpersonen stärkere Aktivierungen als Alexithyme in zingulären Arealen, dem Corpus callosum sowie rechtsseitigen Frontalregionen. Alexithyme aktivierten stärker Kuneus und Präkuneus, Thalamus (Pulvinar), linksseitig mediale frontale und rechtsseitige frontale Regionen, die rechtsseitige Präzentralregion sowie das Zerebellum. Das Merkmal der Alexithymie ist in dieser Untersuchung unter emotionaler Stimulation verbunden mit einer Aktivierung sprachassoziierter Regionen, während limbische und paralimbische Strukturen signifikant weniger in Anspruch genommen werden als dies bei Normalpersonen der Fall ist.

Abstract

Objective: This study was designed to determine patterns of regional brain activation during emotional stimulation in alexithymics as compared with normal controls. Method: We used ¹⁵O-water positron emission tomography and an emotional stimulation paradigm based upon autobiographic recall of either happy, sad or emotionally neutral situations. 10 normal subjects without medical or psychiatrical history were compared with 9 patients with somatoform disorder without any other DSM-IV diagnosis. TAS-20 was used as a measure for alexithymia, depression was measured using BDI. Results: Normal controls showed significantly greater activation than alexithymics in cingulate areas, corpus callosum, and right superior and inferior frontal gyrus. Alexithymics activated significantly more in cuneus and precuneus, thalamus (pulvinar), left medial frontal, right inferior temporal, left superior temporal regions, left precentral gyrus, and the cerebellum. Conclusions: During emotional autobiographic recall, alexithymia, either trait or state, is characterized by utilization of different brain regions when compared to normal controls. The areas activated by alexithymic persons largely comprise of language related regions, leaving out limbic and paralimbic areas.

Key words

Alexithymia - emotion

Full Text

References

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Priv.-Doz. Dr. med. Michael Huber

Institut und Poliklinik für Psychosomatik und Psychotherapie der Universität zu Köln

50924 Köln

Email: Michael.Huber@Uni-Koeln.de