Evidence map›Paper›PMID 36610493›Full record

ArticleNeuropsychologia2023

The relationship between alexithymia, interoception, and neural functional connectivity during facial expression processing in autism spectrum disorder.

Christiana Butera, Jonas Kaplan, Emily Kilroy, Laura Harrison, Aditya Jayashankar, Fernanda Loureiro, Lisa Aziz-Zadeh

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuropsychologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Associations Between Autism and Self-Reported Dimensions of Interoception.Autism : the international journal of research and practice · 2026
    Article
  6. Review
  7. The inner life of autism: a call to action.Frontiers in pediatrics · 2026
    Article
  8. Article
  9. Article
  10. A sensorimotor basis for facial expressivity differences in autism.Imaging neuroscience (Cambridge, Mass.) · 2025
    Article
  11. Article
  12. Sensorimotor regulation of facial expression - An untouched frontier.Neuroscience and biobehavioral reviews · 2024
    Review
  13. Article
  14. Review
  15. Review
  16. Article
  17. Review
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Christiana ButeraBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA.
Jonas KaplanBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA.
Emily KilroyBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA.
Laura HarrisonBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA.
Aditya JayashankarBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA.
Fernanda LoureiroBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA.
Lisa Aziz-ZadehBrain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA. Electronic address: lazizzad@usc.edu.
University of Southern California · US

Funding

The neurobiological basis of heterogeneous social and motor deficits in ASDR01HD079432 · NICHD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI AZIZ-ZADEH, LISA SARAH, DAPRETTO, MIRELLA · 2015 to 2019
$2.2M
NICHD NIH HHS R01 HD079432
6 · The paper itself

Abstract

Neural processing differences of emotional facial expressions, while common in autism spectrum disorder (ASD), may be related to co-occurring alexithymia and interoceptive processing differences rather than autism per se. Here, we investigate relationships between alexithymia, interoceptive awareness of emotions, and functional connectivity during observation of facial expressions in youth (aged 8-17) with ASD (n = 28) compared to typically developing peers (TD; n = 37). Behaviorally, we found no significant differences between ASD and TD groups in interoceptive awareness of emotions, though alexithymia severity was significantly higher in the ASD group. In the ASD group, increased alexithymia was significantly correlated with lower interoceptive sensation felt during emotion. Using psycho-physiological interaction (PPI) analysis, the ASD group showed higher functional connectivity between the left ventral anterior insula and the left lateral prefrontal cortex than the TD group when viewing facial expressions. Further, alexithymia was associated with reduced left anterior insula-right precuneus connectivity and reduced right dorsal anterior insula-left ventral anterior insula connectivity when viewing facial expressions. In the ASD group, the degree of interoceptive sensation felt during emotion was positively correlated with left ventral anterior insula-right IFG connectivity when viewing facial expressions. However, across all participants, neither alexithymia nor interoceptive awareness of emotions predicted connectivity between emotion-related brain regions when viewing emotional facial expressions. To summarize, we found that in ASD compared to TD: 1) there is stronger connectivity between the insula and lateral prefrontal cortex; and 2) differences in interhemispheric and within left hemisphere connectivity between the insula and other emotion-related brain regions are related to individual differences in interoceptive processing and alexithymia. These results highlight complex relationships between alexithymia, interoception, and brain processing in ASD.

Indexed as

Autism Spectrum DisorderInteroceptionAdolescentAffective SymptomsEmotionsFacial ExpressionHumansMagnetic Resonance ImagingAlexithymiaAutism spectrum disorderEmpathyFacial expressionsFunctional connectivityInteroception

Identifiers

PMID36610493
PMCPMC9898240
OpenAlexW4313593348

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.