Open Access Highly Accessed Research article

Alexithymia and the labeling of facial emotions: response slowing and increased motor and somatosensory processing

Klas Ihme1, Julia Sacher23, Vladimir Lichev1, Nicole Rosenberg1, Harald Kugel4, Michael Rufer5, Hans-Jörgen Grabe67, André Pampel8, Jöran Lepsien8, Anette Kersting1, Arno Villringer23 and Thomas Suslow19*

Author Affiliations

1 Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany

2 Department of Neurology, Max-Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany

3 Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany

4 Department of Clinical Radiology, University of Münster, Münster, Germany

5 Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland

6 Department of Psychiatry, University of Greifswald, Greifswald, Germany

7 HELIOS Hospital, Stralsund, Germany

8 Nuclear Magnetic Resonance Unit, Max-Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany

9 Department of Psychiatry, University of Münster, Münster, Germany

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BMC Neuroscience 2014, 15:40  doi:10.1186/1471-2202-15-40

Published: 14 March 2014



Alexithymia is a personality trait that is characterized by difficulties in identifying and describing feelings. Previous studies have shown that alexithymia is related to problems in recognizing others’ emotional facial expressions when these are presented with temporal constraints. These problems can be less severe when the expressions are visible for a relatively long time. Because the neural correlates of these recognition deficits are still relatively unexplored, we investigated the labeling of facial emotions and brain responses to facial emotions as a function of alexithymia.


Forty-eight healthy participants had to label the emotional expression (angry, fearful, happy, or neutral) of faces presented for 1 or 3 seconds in a forced-choice format while undergoing functional magnetic resonance imaging. The participants’ level of alexithymia was assessed using self-report and interview. In light of the previous findings, we focused our analysis on the alexithymia component of difficulties in describing feelings. Difficulties describing feelings, as assessed by the interview, were associated with increased reaction times for negative (i.e., angry and fearful) faces, but not with labeling accuracy. Moreover, individuals with higher alexithymia showed increased brain activation in the somatosensory cortex and supplementary motor area (SMA) in response to angry and fearful faces. These cortical areas are known to be involved in the simulation of the bodily (motor and somatosensory) components of facial emotions.


The present data indicate that alexithymic individuals may use information related to bodily actions rather than affective states to understand the facial expressions of other persons.

Alexithymia; Supplementary motor area; Somatosensory cortex; Facial emotion; Labeling; Toronto structured interview for Alexithymia