P2‐246: Neural Circuitry of Grief in Dementia Caregivers

Family dementia caregivers frequently suffer from a toll of intense grief in addition to depression while caring for their loved ones. Caregivers with high levels of psychological symptoms are more vulnerable to infection and exhibit early mortality. However, little is known about the neural underpinnings of grief and depression in this vulnerable population. We undertook the first neuroimaging study of grief in dementia caregivers. 18 caregivers were enrolled in a functional magnetic resonance imaging (fMRI) protocol as part of a larger trial of a meditation and guided imagery intervention for caregiver depression. Clinical measures included the Hamilton Depression Rating Scale and the Marwit-Meuser Grief Inventory. During fMRI scanning, caregivers were shown faces of either their dementia-stricken relative or that of a stranger who was matched for age, race and gender. These images were coupled randomly with grief-eliciting or neutral words, in a 2 x 2 design. Differential brain activation was assessed between relative coupled with grief words versus stranger coupled with grief words, and the resulting activation maps were correlated with grief severity and depression. Grief and depression symptom severity were correlated (Pearson r2 = .48, p < .05). Corrected for multiple comparisons, the association of brain activity with grief symptoms revealed diffuse right-sided activation of the frontal pole and posterior cingulate gyrus. Left-sided regions engaged included planum temporale and left precuneous. There were no correlations of brain activation during this task with depression symptoms.