Can't Stop Remembering: Neural Decoding of Representations of the Deceased Predicts Subsequent Intrusive Thinking and Coping Strategies.

Is there a neural signature for close loved ones after they die? Can that signature predict persistently intrusive thoughts of the loved one? Does knowledge of brain processes involved in thinking about the deceased allow us to better understand maladaptive grieving processes that may interfere with life functioning? Grief and complicated grief constitute one area that is dramatically understudied in the field (1,2), and the clues within study of grief may offer a window into understanding how to avoid complicated grief. Grieving is often elucidated by self-report, and different proxies are needed to better reflect deceased-related thinking. While the topic of complicated grief is not new, it has long been understood that grief over loss/bereavement might be categorically different from major depressive disorder. Moreover, discussion of the concept of complicated grief has emerged in the DSM only recently, again, as distinct from major depressive disorder. Individuals who treat this condition as well as individuals who experience it acknowledge many of the same symptoms and feelings as observed in major depressive disorder, but they deny that it is the same process. Thus, we turn to the neural systems involved in loss and grief to potentially arbitrate between the idea that grief over a deceased loved one might have a unique neural signature and a corresponding unique impact on the affected individual. The study by Schneck et al. (3) addresses this knowledge gap. They employed a number of innovative strategies to better elucidate how deceased-related thinking (thinking or thoughts or neural signature representative of the loved one) might be measured at the neural level and how this neural representation can discriminate and predict subsequent deceased-related thinking that emerges during a “mindless” sustained attention task sensitive to mind-wandering and reflects avoidance coping strategies. Briefly, Schneck et al. demonstrate 1) that they can decode a neural pattern of circuits engaged in thoughts about the deceased loved one, 2) that this machine-learned pattern of circuits can be modeled to identify the intrusion caused by thoughts of the loved one on a subsequent cognitive task, and 3) that such thinking is unique to the deceased and reflects extent of subject-specific avoidance. There are also some important methodological steps taken and related challenges that we will briefly highlight before discussing the implications and the possible next steps. Functional magnetic resonance imaging relies on differences in relative measurements in blood flow, often based on subtraction techniques in which a condition of interest is