Experiencing the death of a loved one is inevitable, and grief is a natural response. Most grieving adults are resilient and recover their pre-loss functioning within a year; however, about 10 percent develop intense and debilitating grief, also known as prolonged grief disorder, or complicated grief. Those individuals face detrimental medical and cognitive health outcomes and have an increased risk of suicide and premature death.
The Medical College of Wisconsin (MCW) has received a five-year, $2.6 million grant from the National Institutes of Health (NIH) National Institute of Mental Health (NIMH) to study how changes in brain activity might signal which bereaved individuals are at high risk for a complicated grief symptom trajectory and development of prolonged grief disorder. This is the first such comprehensive brain imaging study on grief and loss in the country to receive NIMH funding.
Principal investigator on the study Joseph S. Goveas, MD, associate professor in the Department of Psychiatry and Behavioral Medicine and Institute for Health and Equity and director of geriatric psychiatry at MCW, and his research team will enroll 115 participants aged 50 years and older who have experienced the loss of a loved one within the last six months. Each participant will complete multiple clinical assessments and brain scans over the course of one year, with the goal of identifying any changes in the brain that signal whether or not the individual will experience a complicated grief trajectory. A comparison group of 55 non-grieving individuals will also complete clinical assessments and brain scans.
“Despite the magnitude of this problem, we are currently not able to distinguish the biological differences between those who are resilient from those who are prone to complicated grief trajectories,” said Dr. Goveas. “Brain imaging-based markers that can characterize the clinical course during the first year for those experiencing acute grief are critically needed.”
Based on the results of a pilot study by Dr. Goveas’ team that began in 2016, the researchers believe that in adults with acute grief, features of emotion dysregulation in the brain are early and critical measures of complicated grief symptom trajectories and development of prolonged grief disorder. The pilot study looked at brain scans of grieving individuals and revealed that increased activity between the amygdala, a region of the brain that processes negative emotions, and the frontal lobe signaled a greater risk for future complications.
“The goal of this latest NIH-funded study is to validate the findings of the pilot study and identify biomarkers of prolonged grief disorder,” Dr. Goveas said. “Ultimately, we aim to use this knowledge to test treatment or prevention strategies in the most at-risk grieving individuals to prevent future complications, like prolonged grief disorder, depression, cognitive decline and suicide.”