Alexithymia in multiple sclerosis: Clinical and radiological correlations

Area of Science:

• Neuroscience
• Psychiatry
• Radiology

Background:

• Alexithymia, characterized by difficulty identifying and describing emotions, affects a significant portion of the multiple sclerosis (MS) population, with prevalence potentially reaching 53%.
• Understanding the relationship between alexithymia and MS is crucial for comprehensive patient care and management.

Purpose of the Study:

• To ascertain the frequency of alexithymia in individuals with multiple sclerosis (MS).
• To explore correlations between MS-related structural magnetic resonance imaging (MRI) abnormalities, fatigue, and cognitive deficits.

Main Methods:

• A cohort of 95 MS patients across various disease stages, including clinically isolated syndromes (CIS), relapsing-remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS), were evaluated.
• The Toronto Alexithymia Scale (TAS-20) was employed to measure alexithymia, with subsequent correlation analyses performed against cognitive functions, depression, and fatigue.
• Voxel-based morphometry (VBM) MRI analysis was conducted to assess lesion load and cerebral/regional atrophy.

Main Results:

• Alexithymia was identified in 57% of the studied MS patients, with no significant variations observed across different clinical phenotypes.
• Alexithymic MS patients exhibited notable differences in fatigue, depression levels, and information processing speed compared to non-alexithymic individuals.
• Structural MRI revealed reduced cerebral and cerebellar white matter volumes in alexithymic patients, alongside significant associations between alexithymia and diminished volumes in the brainstem, thalamus, and corpus callosum.

Conclusions:

• Alexithymia is prevalent in multiple sclerosis (MS) patients, irrespective of their disease phenotype.
• The study establishes a significant association between alexithymia and white matter atrophy in the cerebrum and cerebellum, as well as in the brainstem, corpus callosum, and thalami.
• These findings underscore the importance of recognizing and addressing alexithymia in MS management due to its link with neuroanatomical changes and functional impairments.