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Amygdala-Centered Emotional Processing in Prolonged Grief Disorder: Relationship With Clinical Symptomatology
Gyujoon Hwang1, Nutta-On P Blair1, B Douglas Ward1
1Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Older adults with prolonged grief disorder (PGD) show heightened amygdala reactivity to negative stimuli, linked to intrusive thoughts. Brain connectivity differences in PGD may explain avoidance and loneliness, suggesting targets for treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Gerontology
Background:
- Prolonged grief disorder (PGD) is a complex condition impacting health.
- Enhanced negative emotional bias is hypothesized to underlie PGD symptoms.
Purpose of the Study:
- To investigate neural differences in emotional processing between older adults with PGD and those with integrated grief.
- To explore the relationship between brain activity, functional connectivity, and clinical symptoms in PGD.
Main Methods:
- Cross-sectional study comparing older adults with probable PGD (n=33) and integrated grief (n=38).
- fMRI emotional face-matching task to assess neural reactivity and functional connectivity (FC).
- Analysis of amygdala, insula, ACC, and dlPFC activity, plus whole-brain regression.
Main Results:
- PGD group exhibited greater right amygdala activation to negative stimuli, correlating with intrusive thoughts.
- Lower resting-state FC between right amygdala and posterior cingulate cortex/precuneus in PGD, linked to avoidance.
- Increased resting-state FC between right amygdala and thalamus in PGD, associated with loneliness.
Conclusions:
- Dysregulated amygdala-centric neural activity and FC differentiate prolonged from integrated grief in older adults.
- These findings suggest enhanced negative bias and related neural mechanisms in PGD.
- Targeting amygdala-centric neural circuit abnormalities may inform PGD treatment strategies.
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