Background: The loss of an only child, known as Shidu in China, is a profoundly distressing experience, often leading to Prolonged Grief Disorder (PGD). Despite its impact, the structural brain alterations associated with PGD, potentially influencing cognitive impairments in Shidu parents, remain understudied.Objective: This study aims to identify brain structural abnormalities related to prolonged grief and their relation with cognitive inhibition in Shidu parents.Methods: The study included 40 Shidu parents and 42 non-bereaved participants. Prolonged grief was evaluated using the Prolonged Grief Questionnaire (PG-13). We employed voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) to assess brain structural alterations and their correlation with cognitive inhibition, as measured by Stroop interference scores.Results: Findings suggest that greater prolonged grief intensity correlates with reduced grey matter volume in the right amygdala and the left supramarginal gyrus (SMG). Additionally, enhanced amygdala-to-whole-brain structural connectivity showed a marginal association with prolonged grief, particularly with emotional-related symptoms. Furthermore, a decrease in SMG volume was found to mediate the relation between prolonged grief and Stroop Time Inference (TI) score, indicating an indirect effect of prolonged grief on cognitive inhibition.Conclusions: The study provides insight into the neural correlates of prolonged grief in Shidu parents, highlighting the SMG's role in cognitive inhibition. These findings emphasise the need for comprehensive grief interventions to address the complex cognitive and emotional challenges faced by this unique bereaved population.
Antecedentes: La pérdida de un hijo único, conocida como Shidu en China, es una experiencia profundamente angustiante que a menudo conduce al Trastorno de Duelo Prolongado (PGD, por sus siglas en inglés). A pesar de su impacto, las alteraciones cerebrales estructurales asociadas al PGD, que pueden influir en los deterioros cognitivos de los padres cursando Shidu, siguen siendo poco estudiadas.
Keywords: Prolonged grief disorder; Shidu parents; Trastorno por duelo prolongado; cognitive inhibition; diffusion tensor imaging; imagenología con tensor de difusión; inhibición cognitiva; morfometría basada en vóxel; padres Shidu; voxel-based morphometry.
The Shidu parents had a delay in cognitive inhibition when performing the Stroop test, compared to the control group.Prolonged grief intensity was linked to decreased grey matter in the right amygdala and a potential increase in amygdala-to-whole-brain structural connectivity. These volumes were associated with prolonged grief symptoms related to emotions.A higher level of prolonged grief was also associated with reduced grey matter volume in the left supramarginal gyrus, mediating the relationship between prolonged grief and Stroop Time Inference score, which indicates cognitive inhibition.