Amygdala-Centered Emotional Processing in Prolonged Grief Disorder: Relationship With Clinical Symptomatology. Biol Psychiatry Cogn Neurosci Neuroimaging 2025 Dec;10(12):1284-1293
Date
12/27/2024Pubmed ID
39725082Pubmed Central ID
PMC12185774DOI
10.1016/j.bpsc.2024.12.008Scopus ID
2-s2.0-105000420540 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
BACKGROUND: Prolonged grief disorder (PGD) is a multidimensional condition with adverse health consequences. We hypothesized that enhanced negative emotional bias characterizes this disorder and underlies its key clinical symptoms.
METHODS: In a cross-sectional design, chronically grieving older adults (age 61.5 ± 8.9 years) experiencing probable PGD (n = 33) were compared with demographic- and time since loss-equated integrated (adaptive) grief participants (n = 38). To probe generalized negative affective reactivity, participants performed an emotional face-matching task during functional magnetic resonance imaging scanning and completed demographic and clinical assessments. Contrast maps (fearful + angry faces [-] shapes) were generated to determine group differences in brain activity within hypothesized affective and regulatory processing regions (amygdala, anterior insula, dorsal anterior cingulate, dorsolateral prefrontal cortex) and in exploratory whole-brain regression analyses.
RESULTS: The PGD group showed higher right amygdala activation to negative emotional stimuli than the integrated grief group (pcorrected < .05), which positively correlated with intrusive thoughts. Generalized psychophysiological interaction analysis revealed lower task-dependent functional connectivity (FC) between the right amygdala and posterior cingulate cortex/precuneus in PGD (pcorrected < .05), which negatively correlated with avoidance of loss reminders. Resting-state FC between the identified right amygdala and thalamus was higher in PGD (pcorrected < .05), which negatively correlated with loneliness.
CONCLUSIONS: Dysregulated amygdala-centric neural activity and FC during processing of negative affective stimuli and at rest appear to differentiate prolonged from integrated grief in older adults. Future investigations that use interventions to target amygdala-centric neural circuit abnormalities may provide new insights into the role of enhanced negative bias and related mechanisms that underlie PGD and support treatment efficacy.
Author List
Hwang G, Blair NP, Ward BD, McAuliffe TL, Claesges SA, Webber AR, Hainsworth KR, Wang Y, Reynolds CF, Stein EA, Goveas JSAuthors
Joseph S. Goveas MBBS, MD Professor in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinKeri Hainsworth PhD Director, Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Gyujoon Hwang PhD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Timothy L. McAuliffe PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Yang Wang MD Professor in the Radiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAmygdala
Brain Mapping
Cross-Sectional Studies
Emotions
Facial Recognition
Female
Grief
Gyrus Cinguli
Humans
Magnetic Resonance Imaging
Male
Middle Aged
