Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers.

Autor:	Jain FA; Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States., Connolly CG; Department of Biomedical Sciences, College of Medicine, Florida State University, Tallahassee, FL, United States., Moore LC; Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.; Institute for Simulation and Training, University of Central Florida, Orlando, FL, United States., Leuchter AF; Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States., Abrams M; Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States., Ben-Yelles RW; Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States., Chang SE; Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States., Ramirez Gomez LA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States., Huey N; Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States., Lavretsky H; Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States., Iacoboni M; Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.; Ahmanson-Lovelace Brain Mapping Center, Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in human neuroscience [Front Hum Neurosci] 2019 May 14; Vol. 13, pp. 155. Date of Electronic Publication: 2019 May 14 (Print Publication: 2019).
DOI:	10.3389/fnhum.2019.00155
Abstrakt:	Background : Family dementia caregivers often suffer from an immense toll of grief while caring for their loved ones. We sought to identify the clinical relationship between grief, depression and mindfulness and identify neural predictors of symptomatology and improvement. Methods : Twenty three family dementia caregivers were assessed at baseline for grief, mindfulness and depression, of which 17 underwent functional magnetic resonance imaging (fMRI). During fMRI, caregivers were shown faces of either their dementia-stricken relative or that of a stranger, paired with grief-related or neutral words. In nine subjects, post fMRI scans were also obtained after 4 weeks of either guided imagery or relaxation. Robust regression was used to predict changes in symptoms with longitudinal brain activation (BA) changes as the dependent variable. Results : Grief and depression symptoms were correlated ( r = 0.50, p = 0.01), and both were negatively correlated with mindfulness ( r = -0.70, p = 0.0002; r = -0.52, p = 0.01). Relative to viewing strangers, caregivers showed pictures of their loved ones (picture factor) exhibited increased activation in the dorsal anterior cingulate gyrus and precuneus. Improvement in grief but not mindfulness or depression was predicted by increased relative BA in the precuneus and anterior cingulate (different subregions from baseline). Viewing grief-related vs. neutral words elicited activity in the medial prefrontal cortex and precuneus. Conclusions : Caregiver grief, depression and mindfulness are interrelated but have at least partially nonoverlapping neural mechanisms. Picture and word stimuli related to caregiver grief evoked brain activity in regions previously identified with bereavement grief. These activation foci might be useful as biomarkers of treatment response.
Databáze:	MEDLINE
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