Answered on July 17, 2024
Grief and Brain Rewiring: Evidence-Based Insights
Grief, particularly in its complicated or prolonged forms, has been shown to induce significant changes in brain structure and function. Functional and structural neuroimaging studies provide compelling evidence that grief can indeed "rewire" the brain.
1. Functional Connectivity Changes: Research using functional MRI (fMRI) has demonstrated that grief can alter functional connectivity in key brain circuits. For instance, a study by Kark et al. found that mothers grieving the loss of a child exhibited increased functional activation in the Ventral Attention/Salience Networks and reduced activation in the medial prefrontal cortex when exposed to images of their deceased child. Additionally, heightened resting-state functional connectivity between the paraventricular thalamic nucleus and the amygdala was correlated with subjective grief severity.[1]
2. Structural Changes: Structural neuroimaging has also revealed alterations in brain anatomy associated with grief. For example, the same study by Kark et al. noted that maternal grief severity was linked to changes in corticolimbic white matter tracts. This suggests that grief can lead to structural reorganization in brain regions involved in emotional processing and memory.[1]
3. Neurobiological Mechanisms: The neurobiological underpinnings of grief involve several brain regions, including the amygdala, anterior cingulate cortex, and orbitofrontal cortex. These areas are implicated in emotional regulation, reward processing, and social attachment. Fernández-Alcántara et al. found that individuals with complicated grief showed greater activation in the amygdala and other regions when exposed to death-related pictures, indicating heightened emotional reactivity.[2]
4. Therapeutic Interventions: Interventions such as Mindfulness-Based Cognitive Therapy (MBCT) have been shown to modulate these neural changes. Huang et al. reported that MBCT could reduce internetwork connectivity in the salience, default-mode, and fronto-parietal networks, suggesting a potential for neural reorganization and improved emotional regulation in bereaved individuals.[3]
In summary, grief can indeed rewire the brain, affecting both functional connectivity and structural integrity in regions associated with emotional processing and memory. These changes underscore the profound impact of grief on neural circuits and highlight the importance of targeted therapeutic interventions.

References

1.
Why Do Mothers Never Stop Grieving for Their Deceased Children? Enduring Alterations of Brain Connectivity and Function.

Kark SM, Adams JG, Sathishkumar M, et al.

Frontiers in Human Neuroscience. 2022;16:925242. doi:10.3389/fnhum.2022.925242. Copyright License: CC BY

A child's death is a profound loss for mothers and affects hundreds of thousands of women. Mothers report inconsolable and progressive grief that is distinct from depression and impacts daily emotions and functions. The brain mechanisms responsible for this relatively common and profound mental health problem are unclear, hampering its clinical recognition and care. In an initial exploration of this condition, we used resting state functional MRI (fMRI) scans to examine functional connectivity in key circuits, and task-based fMRI to examine brain network activity in grieving mothers in response to pictures of their deceased child and as well as recognizable deceased celebrities and unfamiliar individuals. We compared nine mothers who had lost an adult child and aged-matched control mothers with a living child of a similar age. Additionally, we collected diffusion imaging scans to probe structural connectivity and complemented the imaging studies with neuropsychological assessments. Increased functional activation in Ventral Attention/Salience Networks accompanied by a reduced activation in the medial prefrontal cortex in response to the deceased child's picture robustly distinguished the grieving mothers from controls. Heightened resting-state functional connectivity between the paraventricular thalamic nucleus (PVT) and the amygdala distinguished the grieving mothers from the controls and correlated with subjective grief severity. Structurally, maternal grief and its severity were associated with alterations in corticolimbic white matter tracts. Finally, grieving mothers performed worse than controls on neuropsychological tests of learning, memory, and executive function, linked with grief severity. Reduced activation in cortical regions inhibiting emotions and changes in the PVT circuitry-a region involved in long-term emotional memories and decision making under conflict-distinguish grieving mothers from controls. Notably, the magnitude of neurobiological changes correlates with the subjective severity of grief. Together, these new discoveries delineate a prevalent and under-recognized mental health syndrome and chart a path for its appreciation and care.

2.
Increased Amygdala Activations During the Emotional Experience of Death-Related Pictures in Complicated Grief: An fMRI Study.

Fernández-Alcántara M, Verdejo-Román J, Cruz-Quintana F, et al.

Journal of Clinical Medicine. 2020;9(3):E851. doi:10.3390/jcm9030851. Copyright License: CC BY

Complicated grief (CG) is associated with alterations in various components of emotional processing. The main aim of this study was to identify brain activations in individuals diagnosed with CG while they were observing positive, negative, and death-related pictures. The participants included 19 individuals with CG and 19 healthy non-bereaved (NB) individuals. Functional magnetic resonance imaging (fMRI) scans were obtained during an emotional experience task. The perception of death-related pictures differed between the CG group and the NB group, with a greater activation in the former of the amygdala, putamen, hypothalamus, middle frontal gyrus, and anterior cingulate cortex. Amygdala and putamen activations were significantly correlated with Texas Revised Inventory of Grief scores in the CG group, suggesting that the higher level of grief in this group was associated with a greater activation in both brain areas while watching death-related pictures. A significant interaction between image type and group was observed in the amygdala, midbrain, periaqueductal gray, cerebellum, and hippocampus, largely driven by the greater activation of these areas in the CG group when watching death-related pictures and the lower activation when watching positive-valence pictures. In this study, individuals with CG showed significantly distinct brain activations in response to different emotional images.

3.
Mindfulness-Based Cognitive Therapy on Bereavement Grief: Alterations of Resting-State Network Connectivity Associate With Changes of Anxiety and Mindfulness.

Huang FY, Hsu AL, Chao YP, et al.

Human Brain Mapping. 2021;42(2):510-520. doi:10.1002/hbm.25240.

Bereavement, the experience of losing a loved one, is one of the most catastrophic but inevitable events in life. It causes grief and intense depression-like sadness. Recent studies have revealed the effectiveness and proficiency of mindfulness-based cognitive therapy (MBCT) in emotional regulation among bereavement populations. MBCT improves the well-being of the bereaved by enhancing cognitive performances. Regarding the neural correlates of bereavement grief, previous studies focused on the alleviation of emotion-cognition interferences at specific brain regions. Here, we hypothesized that the bereavement grief fundamentally triggers global alterations in the resting-state brain networks and part of the internetwork connectivity could be reformed after MBCT intervention. We recruited 19 bereaved individuals who participated the 8-week MBCT program. We evaluated (a) the large-scale changes in brain connectivity affected by the MBCT program; as well as (b) the association between connectivity changes and self-rated questionnaire. First, after MBCT, the bereaved individuals showed the reduction of the internetwork connectivity in the salience, default-mode and fronto-parietal networks in the resting state but not under emotional arousal, implying the alleviated attention to spontaneous mind wandering after MBCT. Second, the alterations of functional connectivity between subcortical (e.g., caudate) and cortical networks (e.g., cingulo-opercular/sensorimotor) were associated with the changes of the mindfulness scale, the anxiety and the emotion regulation ability. In summary, MBCT could enhance spontaneous emotion regulation among the bereaved individuals through the internetwork reorganizations in the resting state.