Abstract
ISSN 1758-2024 10.2217/NMT.12.31 © 2012 Future Medicine Ltd Neurodegen. Dis. Manage. (2012) 2(4), 343–346 part of Parkinson’s disease (PD) is a neuro degenerative disorder previously thought to be almost exclusively characterized by motor symptoms such as rigidity, brady kinesia, postural instability and rest tremor. However, motor symptoms are only one aspect of this multifaceted and complex disorder, which is also character ized by nonmotor phenomena such as mood and anxiety disorders [1,2], impair ment of facial emotion expression recog nition [3,4], affective prosody and verbal emotional communication [5,6]. Alexithymia is one PD nonmotor phe nomenon that is still poorly understood. It was originally defined as the inability to recognize and verbalize emotions [7]. People with alexithymia have reduced or missing imagery, they lack introspection ability and are inclined to adopt conform ist behavior. They frequently develop dependent relationships or, alternatively, prefer social isolation. Generally, people with alexithymia are unable to symbol ize or mentalize emotions. Indeed, these patients do not cognitively elaborate emo tions or conceptualize them by mental imaging or words. In alexithymic patients, emotion is just a physical and presymbolic perception. Therefore, alexithymia may be related to lost or reduced empathetic ability and, thus, may negatively affect other aspects of emotional processing, such as recog nition of facial emotion expressions. In other words, ‘if I am unable to compre hend, give meaning to and recognize my emotions how can I understand and feel other people’s emotions?’ In this regard, the brain structures that respond to emo tions have also been shown to be activated during the process of identification of the same emotions by others [8,9], suggesting that anatomical or functional derange ment of discrete neural pathways may lead to the inability to experience emotions as well as impaired recognition of the emo tions expressed by others. In particular, the ability to attribute mental states to others to understand and predict their emotional behavior, that is, the socalled empathetic process, requires the inter vention of several structures such as the amygdala, the temporal lobe (particularly
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