Resting-state functional connectivity and alexithymia: Preliminary predictive evidence

Alexithymia, defined by reduced emotional awareness, is prevalent in psychiatric and substance use disorders; however, its relationship with brain circuitry remains insufficiently understood. Investigating alexithymia in healthy adults enables identification of core brain networks underlying disrupted emotional awareness, independent of comorbid pathology, and may inform the development of targeted interventions. In this study, 150 healthy individuals were assessed using the Toronto Alexithymia Scale (TAS-20) and underwent resting-state functional magnetic resonance imaging. Predictive modeling was applied to whole-brain functional connectivity data to identify network patterns predictive of individual differences in alexithymia. Distinct brain patterns emerged for the TAS-20 total score and the Difficulty Describing Feelings (DDF) subscale. For total alexithymia, the right thalamus and left dorsolateral prefrontal cortex (dlPFC) were implicated. Higher total alexithymia was associated with reduced connectivity between the thalamus and posterior insula and sensorimotor regions, as well as decreased connectivity between the dlPFC and the cerebellum, medial temporal lobe, and frontal cortex. For the DDF subscale, the left premotor cortex (PMC) was identified as a central node, with higher DDF scores linked to reduced connectivity between the left PMC and both the anterior insula and dorsal anterior cingulate cortex. Overall, decreased connectivity among sensory integration, cognitive control, and motor planning networks modestly predicted core features of alexithymia. These findings provide preliminary evidence for the neural networks underlying individual differences in emotional processing and provide a framework for future research on vulnerability to psychiatric disorders and the development of targeted, circuit-based interventions.