Emotional awareness in patients with amyotrophic lateral sclerosis

Neurol Sci. 2024 Oct;45(10):5043-5046. doi: 10.1007/s10072-024-07671-w. Epub 2024 Jul 2.

Abstract

Introduction: It has been recently acknowledged that deficits in experiencing and processing one's own emotions, also termed alexithymia, may possibly feature the frontotemporal-spectrum disorders. This study aims to determine whether alexithymia could be included within the frontotemporal syndromes of amyotrophic lateral sclerosis (ALS).

Methods: Alexithymic traits were estimated in a cohort of 68 non-demented ALS patients with the 20-item Toronto Alexithymia Scale (TAS-20). Patients were assessed for the identification of motor-phenotypes and frontotemporal syndromes based on current classification criteria. Spearman's coefficients explored the correlates of TAS-20 measures with motor-functional profiles, global cognitive, social-cognitive (emotion recognition and empathy) and behavioral status.

Results: Abnormal TAS-20 scores were found in 13% of patients, and their distribution did not vary within motor and frontotemporal phenotypes. Significant associations were detected between TAS-20 and executive (p ≤ .011), memory (p = .006), state-anxiety (p ≤ .013) and depression measures (p ≤ .010). By contrast, TAS-20 scores were unrelated to social-cognitive performances, dysexecutive and apathetic profiles. Disease duration was the only motor-functional feature being related to the TAS-20 (p ≤ .008).

Conclusions: Alexithymia of potential clinical relevance occur in a minority of ALS patients, and its neuropsychological correlates mostly resemble those featuring the general population. Hence, it is unlikely that alexithymia is a specific feature of frontotemporal-spectrum characterizing ALS, rather it could be an expression of psychogenic factors as a reaction to the disease.

Keywords: Alexithymia; Amyotrophic lateral sclerosis; Frontotemporal degeneration; Neuropsychology; Social cognition.

MeSH terms

  • Affective Symptoms* / etiology
  • Affective Symptoms* / physiopathology
  • Aged
  • Amyotrophic Lateral Sclerosis* / complications
  • Amyotrophic Lateral Sclerosis* / psychology
  • Awareness / physiology
  • Cohort Studies
  • Emotions / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests