Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation
Open accessAbstract
Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief.
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Affected brain areas in prolonged grief disorder include the amygdala, the orbitofrontal cortex, the subgenual anterior cingulate cortex, the nucleus accumbens and the insula.
“Affected areas include the amygdala, the orbitofrontal cortex, the subgenual anterior cingulate cortex, the nucleus accumbens and the insula 96-101 .”
From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [101]
The Results report orbitofrontal differences and greater insula activation in the non-complicated-grief group than in the complicated-grief group; the Introduction also reports nucleus accumbens activity in adults with complicated grief. The copy does not identify the subgenual anterior cingulate as affected, and its amygdala finding concerns acutely bereaved people who were not assessed for complicated grief. The five-area list is therefore only partly supported. (LLM, conf=0.86)
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- Authors
- Arizmendi, B., Kaszniak, A. W., & O'Connor, M.-F.
- Affiliations
- University of Arizona (US)
- Corresponding author
- Arizmendi, Brian
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 124
- Issue
- Pt A
- Pages
- 968-976
- ISSN
- 1053-8119 (ISSN-L)
- PMC
- PMC4668712
- OpenAlex
- W1818059334
- Cited by
- 57
- References
- 59
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 7 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 5 · 2016: 1
- FWCI
- 4.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (K01AG028404)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Keywords
- complicated grief, emotional processing, prefrontal cortex, anterior cingulate cortex, rostral anterior cingulate cortex, dorsal anterior cingulate cortex, orbitofrontal cortex, older adults
- MeSH terms
- Aged, Aged, 80 and over, Attention, Brain Mapping, Emotions, Female, Grief, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Nerve Net, Neuropsychological Tests, Recruitment, Neurophysiological, Prefrontal Cortex, Stroop Test
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