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Amygdala Functional Connectivity Features in Grief: A Pilot Longitudinal Study

Published:March 09, 2020DOI:https://doi.org/10.1016/j.jagp.2020.02.014

      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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