Najib Arif, Lorberbaum Jeffrey P, Kose Samet, Bohning Daryl E, George Mark S
Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Psychiatry. 2004 Dec;161(12):2245-56. doi: 10.1176/appi.ajp.161.12.2245.
Separation from loved ones commonly leads to grief reactions. In some individuals, grief can evolve into a major depressive episode. The brain regions involved in grief have not been specifically studied. The authors studied brain activity in women actively grieving a recent romantic relationship breakup. It was hypothesized that while remembering their ex-partner, subjects would have altered brain activity in regions identified in sadness imaging studies: the cerebellum, anterior temporal cortex, insula, anterior cingulate, and prefrontal cortex.
Nine right-handed women whose romantic relationship ended within the preceding 4 months were studied. Subjects were scanned using blood-oxygen-level-dependent functional magnetic resonance imaging while they alternated between recalling a sad, ruminative thought about their loved one (grief state) and a neutral thought about a different person they knew an equally long time.
Acute grief (grief minus neutral state) was associated with increased group activity in posterior brain regions, including the cerebellum, posterior brainstem, and posterior temporoparietal and occipital brain regions. Decreased activity was more prominent anteriorly and on the left and included the anterior brainstem, thalamus, striatum, temporal cortex, insula, and dorsal and ventral anterior cingulate/prefrontal cortex. When a more lenient statistical threshold for regions of interest was used, additional increases were found in the lateral temporal cortex, supragenual anterior cingulate/medial prefrontal cortex, and right inferomedial dorsolateral prefrontal cortex, all of which were adjacent to spatially more prominent decreases. In nearly all brain regions showing brain activity decreases with acute grief, activity decreases were greater in women reporting higher grief levels over the past 2 weeks.
During acute grief, subjects showed brain activity changes in the cerebellum, anterior temporal cortex, insula, anterior cingulate, and prefrontal cortex, consistent with the hypothesis. Subjects with greater baseline grief showed greater decreases in all these regions except for the cerebellum. Further imaging studies are needed to understand the relationship between normal sadness, grief, and depression.
与亲人分离通常会引发悲伤反应。在一些人身上，悲伤可能会演变成重度抑郁发作。悲伤所涉及的脑区尚未得到专门研究。作者对近期因浪漫关系破裂而处于悲痛中的女性的大脑活动进行了研究。研究假设是，在回忆其前任伴侣时，受试者在悲伤成像研究中所确定的区域（小脑、颞叶前皮质、脑岛、前扣带回和前额叶皮质）的大脑活动会发生改变。
对9名右利手女性进行了研究，她们的浪漫关系在之前4个月内结束。受试者在交替回忆关于其爱人的悲伤、反复思索的想法（悲伤状态）和关于她们认识同样长时间的另一个人的中性想法时，使用血氧水平依赖性功能磁共振成像进行扫描。
急性悲伤（悲伤状态减去中性状态）与后脑区域的群体活动增加有关，包括小脑、后脑干以及颞顶叶后部和枕叶脑区。活动减少在前部和左侧更为明显，包括前脑干、丘脑、纹状体、颞叶皮质、脑岛以及背侧和腹侧前扣带回/前额叶皮质。当对感兴趣区域使用更宽松的统计阈值时，在颞叶外侧皮质、膝上型前扣带回/内侧前额叶皮质以及右侧下内侧背外侧前额叶皮质中发现了额外的活动增加，所有这些区域在空间上都与更明显的活动减少相邻。在几乎所有显示随着急性悲伤大脑活动减少的脑区中，过去2周报告悲伤程度较高的女性活动减少幅度更大。
在急性悲伤期间，受试者在小脑、颞叶前皮质、脑岛、前扣带回和前额叶皮质出现了大脑活动变化，与假设一致。除小脑外，基线悲伤程度较高的受试者在所有这些区域的活动减少幅度更大。需要进一步的成像研究来了解正常悲伤、悲痛和抑郁之间的关系。
