Highlights
- •Do amygdala-based brain network features cross-sectionally explain the symptom variance and longitudinally associate with complicated grief symptom trajectories after an attachment loss?
- •Increased amygdala functional connectivity in the posterior default mode, fusiform gyri, and thalamus was observed in grief participants. Increased baseline amygdala functional connections with the ventral affective and default mode areas cross-sectionally correlated with higher grief symptoms, and the executive control and salience network regions correlated with worsening grief symptoms over time.
- •Amygdala-based brain network measures may have biomarker potential in complicated grief.
Abstract
Objective
Acute grief, in an important minority of older adults, can become protracted, intense,
and debilitating, leading to the development of complicated grief (CG). However, the
neurobiologic mechanisms underlying a maladaptive grief response after an attachment
loss are unknown. The current study aimed to examine the amygdala brain network features
that cross-sectionally explain the symptom variance and longitudinally relate to grief
symptom trajectories after an attachment loss.
Methods
Baseline amygdala functional connectivity (Fc) was assessed using a seed-based resting-state
functional magnetic resonance imaging method in 35 adults who were within 1-year after
death of a loved one and 21 healthy comparison (HC) participants. Magnetic resonance
imaging scans were obtained at baseline, and clinical assessments, including the inventory
of complicated grief (ICG) were completed at weeks 0, 8, 16, and 26 (endpoint).
Results
Relative to HC participants, grief participants showed increased amygdala Fc in the
posterior default mode (bilateral medial temporal lobes and left precuneus) and thalamus.
Amygdala Fc in the default mode and ventral affective regions positively correlated
with ICG scores at baseline. Furthermore, increased baseline amygdala functional connections
with the dorsal frontal executive control and salience network regions correlated
with worsening ICG scores over time. These longitudinal findings persisted after controlling
for covariates, including baseline depressive and anxiety symptoms.
Conclusion
These results provide novel preliminary evidence suggesting amygdala-based brain network
measures to cross-sectionally explain symptom variance and longitudinally correlate
with grief symptom trajectories in grievers. Amygdala brain network function measures
may have the potential to serve as biomarkers of CG.
Key Words
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Article info
Publication history
Published online: March 09, 2020
Accepted:
February 28,
2020
Received in revised form:
February 18,
2020
Received:
September 10,
2019
Identification
Copyright
© 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
