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Ribeiro M, Yordanova YN, Noblet V, Herbet G, Ricard D. White matter tracts and executive functions: a review of causal and correlation evidence. Brain 2024; 147:352-371. [PMID: 37703295 DOI: 10.1093/brain/awad308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
Executive functions are high-level cognitive processes involving abilities such as working memory/updating, set-shifting and inhibition. These complex cognitive functions are enabled by interactions among widely distributed cognitive networks, supported by white matter tracts. Executive impairment is frequent in neurological conditions affecting white matter; however, whether specific tracts are crucial for normal executive functions is unclear. We review causal and correlation evidence from studies that used direct electrical stimulation during awake surgery for gliomas, voxel-based and tract-based lesion-symptom mapping, and diffusion tensor imaging to explore associations between the integrity of white matter tracts and executive functions in healthy and impaired adults. The corpus callosum was consistently associated with all executive processes, notably its anterior segments. Both causal and correlation evidence showed prominent support of the superior longitudinal fasciculus to executive functions, notably to working memory. More specifically, strong evidence suggested that the second branch of the superior longitudinal fasciculus is crucial for all executive functions, especially for flexibility. Global results showed left lateralization for verbal tasks and right lateralization for executive tasks with visual demands. The frontal aslant tract potentially supports executive functions, however, additional evidence is needed to clarify whether its involvement in executive tasks goes beyond the control of language. Converging evidence indicates that a right-lateralized network of tracts connecting cortical and subcortical grey matter regions supports the performance of tasks assessing response inhibition, some suggesting a role for the right anterior thalamic radiation. Finally, correlation evidence suggests a role for the cingulum bundle in executive functions, especially in tasks assessing inhibition. We discuss these findings in light of current knowledge about the functional role of these tracts, descriptions of the brain networks supporting executive functions and clinical implications for individuals with brain tumours.
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Affiliation(s)
- Monica Ribeiro
- Service de neuro-oncologie, Hôpital La Pitié-Salpêtrière, Groupe Hospitalier Universitaire Pitié Salpêtrière-Charles Foix, Sorbonne Université, 75013 Paris, France
- Université Paris Saclay, ENS Paris Saclay, Service de Santé des Armées, CNRS, Université Paris Cité, INSERM, Centre Borelli UMR 9010, 75006 Paris, France
| | - Yordanka Nikolova Yordanova
- Service de neurochirurgie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, 92140 Clamart, France
| | - Vincent Noblet
- ICube, IMAGeS team, Université de Strasbourg, CNRS, UMR 7357, 67412 Illkirch, France
| | - Guillaume Herbet
- Praxiling, UMR 5267, CNRS, Université Paul Valéry Montpellier 3, 34090 Montpellier, France
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34295 Montpellier, France
- Institut Universitaire de France
| | - Damien Ricard
- Université Paris Saclay, ENS Paris Saclay, Service de Santé des Armées, CNRS, Université Paris Cité, INSERM, Centre Borelli UMR 9010, 75006 Paris, France
- Département de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, 92140 Clamart, France
- Ecole du Val-de-Grâce, 75005 Paris, France
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Hu Y, Li G, Zhang W, Wang J, Ji W, Yu J, Han Y, Cui G, Wang H, Manza P, Volkow N, Ji G, Wang GJ, Zhang Y. Obesity is associated with alterations in anatomical connectivity of frontal-corpus callosum. Cereb Cortex 2024; 34:bhae014. [PMID: 38300178 DOI: 10.1093/cercor/bhae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 02/02/2024] Open
Abstract
Obesity has been linked to abnormal frontal function, including the white matter fibers of anterior portion of the corpus callosum, which is crucial for information exchange within frontal cortex. However, alterations in white matter anatomical connectivity between corpus callosum and cortical regions in patients with obesity have not yet been investigated. Thus, we enrolled 72 obese and 60 age-/gender-matched normal weight participants who underwent clinical measurements and diffusion tensor imaging. Probabilistic tractography with connectivity-based classification was performed to segment the corpus callosum and quantify white matter anatomical connectivity between subregions of corpus callosum and cortical regions, and associations between corpus callosum-cortex white matter anatomical connectivity and clinical behaviors were also assessed. Relative to normal weight individuals, individuals with obesity exhibited significantly greater white matter anatomical connectivity of corpus callosum-orbitofrontal cortex, which was positively correlated with body mass index and self-reported disinhibition of eating behavior, and lower white matter anatomical connectivity of corpus callosum-prefrontal cortex, which was significantly negatively correlated with craving for high-calorie food cues. The findings show that alterations in white matter anatomical connectivity between corpus callosum and frontal regions involved in reward and executive control are associated with abnormal eating behaviors.
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Affiliation(s)
- Yang Hu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Guanya Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Wenchao Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Jia Wang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Weibin Ji
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Juan Yu
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi 710032, China
| | - Yu Han
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, 4 Xinsi Road, Xi'an, Shaanxi 710038, China
| | - Guangbin Cui
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, 4 Xinsi Road, Xi'an, Shaanxi 710038, China
| | - Haoyi Wang
- College of Westa, Southwest University, 2 Tiansheng Road, Chongqing 400715, China
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, MSC1013, Building 10, Room B2L304, Bethesda, MD 20892, USA
| | - Nora Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, MSC1013, Building 10, Room B2L304, Bethesda, MD 20892, USA
| | - Gang Ji
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi 710032, China
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, MSC1013, Building 10, Room B2L304, Bethesda, MD 20892, USA
| | - Yi Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
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Jensen DE, Ebmeier KP, Akbaraly T, Jansen MG, Singh-Manoux A, Kivimäki M, Zsoldos E, Klein-Flügge MC, Suri S. The association of longitudinal diet and waist-to-hip ratio from midlife to old age with hippocampus connectivity and memory in old age: a cohort study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.12.570778. [PMID: 38168259 PMCID: PMC10760001 DOI: 10.1101/2023.12.12.570778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Epidemiological studies suggest lifestyle factors may reduce the risk of dementia. However, few studies have examined the association of diet and waist-to-hip ratio with hippocampus connectivity. In the Whitehall II Imaging Sub-study, we examined longitudinal changes in diet quality in 512 participants and waist-to-hip ratio in 665 participants. Diet quality was measured using the Alternative Health Eating Index-2010 assessed three times across 11 years between ages 48 and 60 years, and waist-to-hip ratio five times over 21 years between ages 48 and 68 years. Brain imaging and cognitive tests were performed at age 70±5 years. We measured white matter using diffusion tensor imaging and hippocampal functional connectivity using resting-state functional magnetic resonance imaging. In addition to associations of diet and waist-to-hip ratio with brain imaging measures, we tested whether associations between diet, waist-to-hip ratio and cognitive performance were mediated by brain connectivity. We found better diet quality in midlife and improvements in diet over mid-to-late life were associated with higher hippocampal functional connectivity to the occipital lobe and cerebellum, and better white matter integrity as measured by higher fractional anisotropy and lower diffusivity. Higher waist-to-hip ratio in midlife was associated with higher mean and radial diffusivity and lower fractional anisotropy in several tracts including the inferior longitudinal fasciculus and cingulum. Associations between midlife waist-to-hip ratio, working memory and executive function were partially mediated by radial diffusivity. All associations were independent of age, sex, education, and physical activity. Our findings highlight the importance of maintaining a good diet and a healthy waist-to-hip ratio in midlife to maintain brain health in later life. Future interventional studies for the improvement of dietary and metabolic health should target midlife for the prevention of cognitive decline in old age.
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Thieleking R, Medawar E, Villringer A, Beyer F, Witte AV. Neurocognitive predictors of food memory in healthy adults - A preregistered analysis. Neurobiol Learn Mem 2023; 205:107813. [PMID: 37625779 DOI: 10.1016/j.nlm.2023.107813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Memory processes have long been known to determine food choices (Rozin & Zellner, 1985) but recognition memory of food and its cognitive, homeostatic and neuroanatomical predictors are still largely understudied. 60 healthy, overweight, non-restrictive eating adults (20 females) took part in a food wanting and subsequent food recognition and lure discrimination task at four time points after a standardized breakfast shake. With advanced tractography of 3 T diffusion-weighted imaging data, we investigated the influence of the uncinate fasciculus' (UF) brain microstructure on the interplay of food wanting and memory processes. The analysis was preregistered in detail and conducted with Bayesian multilevel regression modeling. Target recognition (d') and lure discrimination (LDI) performance of food tended to be higher than of art images while single image food memory accuracy evidently dominated art memory. On this single item level, wanting enhanced recognition accuracy and caloric content enhanced food memory accuracy. The enhancement by reward anticipation was most pronounced during memory encoding. Subjective hunger level did not predict performance on the memory task. The microstructure of the UF did neither evidently affect memory performance outcomes nor moderate the wanting enhancement of the recognition accuracy. Interestingly, female participants outperformed males on the memory task, and individuals with stronger neuroticism showed poorer memory performance. We shed light on to date understudied processes in food decision-making: reward anticipation influenced recognition accuracy and food memory was enhanced by higher caloric content, both effects might shape food decisions. Our findings indicate that brain microstructure does not affect food decision processes in adult populations with overweight. We suggest extending investigation of this interplay to brain activity as well as to populations with eating behaviour disorders.
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Affiliation(s)
- Ronja Thieleking
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.
| | - Evelyn Medawar
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - Frauke Beyer
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - A Veronica Witte
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
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Kitzbichler MG, Martins D, Bethlehem RAI, Dear R, Romero-Garcia R, Warrier V, Seidlitz J, Dipasquale O, Turkheimer F, Cercignani M, Bullmore ET, Harrison NA. Two human brain systems micro-structurally associated with obesity. eLife 2023; 12:e85175. [PMID: 37861301 PMCID: PMC10688972 DOI: 10.7554/elife.85175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
The relationship between obesity and human brain structure is incompletely understood. Using diffusion-weighted MRI from ∼30,000 UK Biobank participants, we test the hypothesis that obesity (waist-to-hip ratio, WHR) is associated with regional differences in two micro-structural MRI metrics: isotropic volume fraction (ISOVF), an index of free water, and intra-cellular volume fraction (ICVF), an index of neurite density. We observed significant associations with obesity in two coupled but distinct brain systems: a prefrontal/temporal/striatal system associated with ISOVF and a medial temporal/occipital/striatal system associated with ICVF. The ISOVF~WHR system colocated with expression of genes enriched for innate immune functions, decreased glial density, and high mu opioid (MOR) and other neurotransmitter receptor density. Conversely, the ICVF~WHR system co-located with expression of genes enriched for G-protein coupled receptors and decreased density of MOR and other receptors. To test whether these distinct brain phenotypes might differ in terms of their underlying shared genetics or relationship to maps of the inflammatory marker C-reactive Protein (CRP), we estimated the genetic correlations between WHR and ISOVF (rg = 0.026, P = 0.36) and ICVF (rg = 0.112, P < 9×10-4) as well as comparing correlations between WHR maps and equivalent CRP maps for ISOVF and ICVF (P<0.05). These correlational results are consistent with a two-way mechanistic model whereby genetically determined differences in neurite density in the medial temporal system may contribute to obesity, whereas water content in the prefrontal system could reflect a consequence of obesity mediated by innate immune system activation.
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Affiliation(s)
| | - Daniel Martins
- Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | | | - Richard Dear
- Department of Psychiatry, University of CambridgeCambridgeUnited Kingdom
| | - Rafael Romero-Garcia
- Department of Psychiatry, University of CambridgeCambridgeUnited Kingdom
- Department of Medical Physiology and Biophysics, Instituto deBiomedicina de Sevilla (IBiS) HUVR/CSIC Universidad de Sevilla/CIBERSAM, ISCIIISevillaSpain
| | - Varun Warrier
- Department of Psychiatry, University of CambridgeCambridgeUnited Kingdom
- Department of Psychology, University of CambridgeCambridgeUnited States
| | - Jakob Seidlitz
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn MedicinePhiladelphiaUnited States
- Department of Child and Adolescent Psychiatry and Behavioral Science,The Children’s Hospital of PhiladelphiaPhiladelphiaUnited States
- Department of Psychiatry, University of PennsylvaniaPhiladelphiaUnited States
| | - Ottavia Dipasquale
- Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | - Federico Turkheimer
- Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | - Mara Cercignani
- Brain Research Imaging Centre, Cardiff UniversityCardiffUnited Kingdom
| | - Edward T Bullmore
- Department of Psychiatry, University of CambridgeCambridgeUnited Kingdom
| | - Neil A Harrison
- Brain Research Imaging Centre, Cardiff UniversityCardiffUnited Kingdom
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Chen AK, Gullett JM, Williamson JB, Cohen RA. Presurgical microstructural coherence predicts cognitive change for bariatric surgery patients. Obesity (Silver Spring) 2023; 31:2325-2334. [PMID: 37605633 PMCID: PMC10449364 DOI: 10.1002/oby.23837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 04/20/2023] [Accepted: 05/17/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE This observational study examined the relationship between presurgical white matter microstructural coherence and cognitive change after weight loss. It was hypothesized that higher baseline fractional anisotropy (FA) would predict greater baseline and change cognition. METHODS A sample of 24 adults (BMI ≥ 35 kg/m2 ) underwent neuropsychological assessment at baseline and 12 weeks after bariatric surgery. A magnetic resonance imaging brain scan was administered at baseline and processed through Tract-Based Spatial Statistics to compute FA in white matter tracts of interest. Composite scores for attention, learning, processing speed, executive function, verbal fluency, working memory, and overall cognition were calculated. RESULTS As expected, FA in some tracts of interest was significantly (p < 0.05) positively associated with change in cognition. Inverse relationships were observed between baseline FA and presurgical cognition, which may be explained by increased medial and radial diffusivity and preserved axonal diffusivity. Cognition generally improved after surgery; however, relative but clinically nonsignificant deterioration was observed on learning measures. Poorer baseline cognitive performance was associated with greater postsurgical cognitive improvement. CONCLUSIONS Presurgical microstructural coherence is associated with magnitude of cognitive change after weight loss. An observed reduction in learning suggests that bariatric surgery may lead to negative outcomes in some cognitive domains, at least temporarily.
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Affiliation(s)
- Alexa K Chen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Joseph M Gullett
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - John B Williamson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Ronald A Cohen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
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Thams F, Li SC, Flöel A, Antonenko D. Functional Connectivity and Microstructural Network Correlates of Interindividual Variability in Distinct Executive Functions of Healthy Older Adults. Neuroscience 2023; 526:61-73. [PMID: 37321368 DOI: 10.1016/j.neuroscience.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
Executive functions, essential for daily life, are known to be impaired in older age. Some executive functions, including working memory updating and value-based decision-making, are specifically sensitive to age-related deterioration. While their neural correlates in young adults are well-described, a comprehensive delineation of the underlying brain substrates in older populations, relevant to identify targets for modulation against cognitive decline, is missing. Here, we assessed letter updating and Markov decision-making task performance to operationalize these trainable functions in 48 older adults. Resting-state functional magnetic resonance imaging was acquired to quantify functional connectivity (FC) in task-relevant frontoparietal and default mode networks. Microstructure in white matter pathways mediating executive functions was assessed with diffusion tensor imaging and quantified by tract-based fractional anisotropy (FA). Superior letter updating performance correlated with higher FC between dorsolateral prefrontal cortex and left frontoparietal and hippocampal areas, while superior Markov decision-making performance correlated with decreased FC between basal ganglia and right angular gyrus. Furthermore, better working memory updating performance was related to higher FA in the cingulum bundle and the superior longitudinal fasciculus. Stepwise linear regression showed that cingulum bundle FA added significant incremental contribution to the variance explained by fronto-angular FC alone. Our findings provide a characterization of distinct functional and structural connectivity correlates associated with performance of specific executive functions. Thereby, this study contributes to the understanding of the neural correlates of updating and decision-making functions in older adults, paving the way for targeted modulation of specific networks by modulatory techniques such as behavioral interventions and non-invasive brain stimulation.
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Affiliation(s)
- Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
| | - Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Faculty of Psychology, TU Dresden, Zellescher Weg 17, 01062 Dresden, Germany; Centre for Tactile Internet with Human-in-the-Loop, TU Dresden, 01062 Dresden, Germany.
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany; German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, 17475 Greifswald, Germany.
| | - Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
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Okeke O, Elbasheir A, Carter SE, Powers A, Mekawi Y, Gillespie CF, Schwartz AC, Bradley B, Fani N. Indirect Effects of Racial Discrimination on Health Outcomes Through Prefrontal Cortical White Matter Integrity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:741-749. [PMID: 35597432 DOI: 10.1016/j.bpsc.2022.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Racial discrimination is consistently associated with adverse health outcomes and has been linked to structural decrements in brain white matter. However, it is unclear whether discrimination-related neuroplastic changes could indirectly affect health outcomes. Our goal was to evaluate indirect associations of racial discrimination on health outcomes through white matter microstructure in a sample of trauma-exposed Black women. METHODS A trauma study in an urban hospital setting recruited 79 Black women who received a history and physical examination to assess medical disorders (compiled into a summed total of disorder types). Participants reported on experiences of racial discrimination and underwent diffusion tensor imaging; fractional anisotropy values were extracted from white matter pathways previously linked to racial discrimination (corpus callosum, including the body and genu; anterior cingulum bundle; and superior longitudinal fasciculus) and entered into mediational models. RESULTS Indirect effects of racial discrimination on medical disorders through left anterior cingulum bundle fractional anisotropy were significant (β = 0.07, SE = 0.04, 95% CI [0.003, 0.14]) after accounting for trauma and economic disadvantage. Indirect effects of racial discrimination on medical disorders through corpus callosum genu fractional anisotropy were also significant (β = 0.08, SE = 0.04, 95% CI [0.01, 0.16]). CONCLUSIONS Racial discrimination may increase risk for medical disorders via neuroplastic effects on microstructural integrity of stress-sensitive prefrontal white matter tracts. Racial discrimination-related changes in these tracts may affect health behaviors, which, in turn, influence vulnerability for medical disorders. These data highlight the connections between racial discrimination, prefrontal white matter connections, and incidence of medical disorders in Black Americans.
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Affiliation(s)
- Onyebuchi Okeke
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Aziz Elbasheir
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Ann C Schwartz
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia; Atlanta VA Medical Center, Decatur, Georgia
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia.
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9
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Kilpatrick LA, An HM, Pawar S, Sood R, Gupta A. Neuroimaging Investigations of Obesity: a Review of the Treatment of Sex from 2010. Curr Obes Rep 2023; 12:163-174. [PMID: 36933153 PMCID: PMC10250271 DOI: 10.1007/s13679-023-00498-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE OF REVIEW To summarize the results of adult obesity neuroimaging studies (structural, resting-state, task-based, diffusion tensor imaging) published from 2010, with a focus on the treatment of sex as an important biological variable in the analysis, and identify gaps in sex difference research. RECENT FINDINGS Neuroimaging studies have shown obesity-related changes in brain structure, function, and connectivity. However, relevant factors such as sex are often not considered. We conducted a systematic review and keyword co-occurrence analysis. Literature searches identified 6281 articles, of which 199 met inclusion criteria. Among these, only 26 (13%) considered sex as an important variable in the analysis, directly comparing the sexes (n = 10; 5%) or providing single-sex/disaggregated data (n = 16, 8%); the remaining studies controlled for sex (n = 120, 60%) or did not consider sex in the analysis (n = 53, 27%). Synthesizing sex-based results, obesity-related parameters (e.g., body mass index, waist circumference, obese status) may be generally associated with more robust morphological alterations in men and more robust structural connectivity alterations in women. Additionally, women with obesity generally expressed increased reactivity in affect-related regions, while men with obesity generally expressed increased reactivity in motor-related regions; this was especially true under a fed state. The keyword co-occurrence analysis indicated that sex difference research was especially lacking in intervention studies. Thus, although sex differences in the brain associated with obesity are known to exist, a large proportion of the literature informing the research and treatment strategies of today has not specifically examined sex effects, which is needed to optimize treatment.
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Affiliation(s)
- Lisa A Kilpatrick
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- David Geffen School of Medicine, Goodman-Luskin Microbiome Center, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Hyeon Min An
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- David Geffen School of Medicine, Goodman-Luskin Microbiome Center, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Shrey Pawar
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Riya Sood
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA.
- David Geffen School of Medicine, Goodman-Luskin Microbiome Center, University of California, Los Angeles, USA.
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA.
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10
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Brooks SJ, Smith C, Stamoulis C. Excess BMI in early adolescence adversely impacts maturating functional circuits supporting high-level cognition and their structural correlates. Int J Obes (Lond) 2023:10.1038/s41366-023-01303-7. [PMID: 37012426 DOI: 10.1038/s41366-023-01303-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND/OBJECTIVES Adverse effects of excess BMI (affecting 1 in 5 children in the US) on brain circuits during neurodevelopmentally vulnerable periods are incompletely understood. This study investigated BMI-related alterations in maturating functional networks and their underlying brain structures, and high-level cognition in early adolescence. SUBJECTS/METHODS Cross-sectional resting-state fMRI, structural sMRI, neurocognitive task scores, and BMI from 4922 youth [median (IQR) age = 120.0 (13.0) months, 2572 females (52.25%)] from the Adolescent Brain Cognitive Development (ABCD) cohort were analyzed. Comprehensive topological and morphometric network properties were estimated from fMRI and sMRI, respectively. Cross-validated linear regression models assessed correlations with BMI. Results were reproduced across multiple fMRI datasets. RESULTS Almost 30% of youth had excess BMI, including 736 (15.0%) with overweight and 672 (13.7%) with obesity, and statistically more Black and Hispanic compared to white, Asian and non-Hispanic youth (p < 0.01). Those with obesity or overweight were less physically active, slept less than recommended, snored more frequently, and spent more time using an electronic device (p < 0.01). They also had lower topological efficiency, resilience, connectivity, connectedness and clustering in Default-Mode, dorsal attention, salience, control, limbic, and reward networks (p ≤ 0.04, Cohen's d: 0.07-0.39). Lower cortico-thalamic efficiency and connectivity were estimated only in youth with obesity (p < 0.01, Cohen's d: 0.09-0.19). Both groups had lower cortical thickness, volume and white matter intensity in these networks' constituent structures, particularly anterior cingulate, entorhinal, prefrontal, and lateral occipital cortices (p < 0.01, Cohen's d: 0.12-0.30), which also mediated inverse relationships between BMI and regional functional topologies. Youth with obesity or overweight had lower scores in a task measuring fluid reasoning - a core aspect of cognitive function, which were partially correlated with topological changes (p ≤ 0.04). CONCLUSIONS Excess BMI in early adolescence may be associated with profound aberrant topological alterations in maturating functional circuits and underdeveloped brain structures that adversely impact core aspects of cognitive function.
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Affiliation(s)
- Skylar J Brooks
- Boston Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Boston, MA, USA
- University of California Berkeley, Helen Wills Neuroscience Institute, Berkeley, CA, USA
| | - Calli Smith
- Boston Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Boston, MA, USA
| | - Catherine Stamoulis
- Boston Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Boston, MA, USA.
- Harvard Medical School, Department of Pediatrics, Boston, MA, USA.
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11
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Liang H, Ernst T, Oishi K, Ryan MC, Herskovits E, Cunningham E, Wilson E, Kottilil S, Chang L. Abnormal brain diffusivity in participants with persistent neuropsychiatric symptoms after COVID-19. NEUROIMMUNE PHARMACOLOGY AND THERAPEUTICS 2023; 2:37-48. [PMID: 37067870 PMCID: PMC10091517 DOI: 10.1515/nipt-2022-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023]
Abstract
Objectives We aimed to compare brain white matter integrity in participants with post-COVID-19 conditions (PCC) and healthy controls. Methods We compared cognitive performance (NIH Toolbox®), psychiatric symptoms and diffusion tensor imaging (DTI) metrics between 23 PCC participants and 24 controls. Fractional anisotropy (FA), axial (AD), radial (RD), and mean (MD) diffusivities were measured in 9 white matter tracts and 6 subcortical regions using MRICloud. Results Compared to controls, PCC had similar cognitive performance, but greater psychiatric symptoms and perceived stress, as well as higher FA and lower diffusivities in multiple white matter tracts (ANCOVA-p-values≤0.001-0.048). Amongst women, PCC had higher left amygdala-MD than controls (sex-by-PCC p=0.006). Regardless of COVID-19 history, higher sagittal strata-FA predicted greater fatigue (r=0.48-0.52, p<0.001) in all participants, and higher left amygdala-MD predicted greater fatigue (r=0.61, p<0.001) and anxiety (r=0.69, p<0.001) in women, and higher perceived stress (r=0.45, p=0.002) for all participants. Conclusions Microstructural abnormalities are evident in PCC participants averaged six months after COVID-19. The restricted diffusivity (with reduced MD) and higher FA suggest enhanced myelination or increased magnetic susceptibility from iron deposition, as seen in stress conditions. The higher amygdala-MD in female PCC suggests persistent neuroinflammation, which might contribute to their fatigue, anxiety, and perceived stress.
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Affiliation(s)
- Huajun Liang
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Thomas Ernst
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Meghann C. Ryan
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Edward Herskovits
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Eric Cunningham
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Eleanor Wilson
- Department of Medicine, Division of Infectious Disease, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shyamasundaran Kottilil
- Department of Medicine, Division of Infectious Disease, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Linda Chang
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
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12
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Brain functional and structural magnetic resonance imaging of obesity and weight loss interventions. Mol Psychiatry 2023; 28:1466-1479. [PMID: 36918706 DOI: 10.1038/s41380-023-02025-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
Obesity has tripled over the past 40 years to become a major public health issue, as it is linked with increased mortality and elevated risk for various physical and neuropsychiatric illnesses. Accumulating evidence from neuroimaging studies suggests that obesity negatively affects brain function and structure, especially within fronto-mesolimbic circuitry. Obese individuals show abnormal neural responses to food cues, taste and smell, resting-state activity and functional connectivity, and cognitive tasks including decision-making, inhibitory-control, learning/memory, and attention. In addition, obesity is associated with altered cortical morphometry, a lowered gray/white matter volume, and impaired white matter integrity. Various interventions and treatments including bariatric surgery, the most effective treatment for obesity in clinical practice, as well as dietary, exercise, pharmacological, and neuromodulation interventions such as transcranial direct current stimulation, transcranial magnetic stimulation and neurofeedback have been employed and achieved promising outcomes. These interventions and treatments appear to normalize hyper- and hypoactivations of brain regions involved with reward processing, food-intake control, and cognitive function, and also promote recovery of brain structural abnormalities. This paper provides a comprehensive literature review of the recent neuroimaging advances on the underlying neural mechanisms of both obesity and interventions, in the hope of guiding development of novel and effective treatments.
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13
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Smith KR, Steele KE, Papantoni A, Harris C, Speck CL, Bakker A, Moran TH, Carnell S, Kamath V. The relationship between weight loss and cognitive function in bariatric surgery. Surg Endosc 2023; 37:1976-1984. [PMID: 36271060 PMCID: PMC10023412 DOI: 10.1007/s00464-022-09581-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previously, we reported short-term improvements in auditory attention, oromotor processing speed, and executive function during the active weight loss phase following bariatric surgery that persisted out to 3 months. In this study, our aims were to investigate the relationship between weight loss and cognitive performance in these patients 1 year following vertical sleeve gastrectomy (VSG) and Roux-en Y gastric bypass (RYGB) surgery and to determine whether preoperative cognitive performance predicted weight loss. METHODS Adult women ages 18-55 approved for bariatric surgery completed a cognitive battery prior to and at 2, 12, 24, and 52 weeks following VSG (N = 17) or RYGB (N = 18). Scores from each task were assigned to one of the following cognitive domains: auditory attention, processing speed, memory, and executive functioning. Weight loss and cognitive scores for each domain were calculated and compared between cohorts. RESULTS RYGB surgery resulted in greater weight loss at 1-year follow-up relative to VSG. Both VSG and RYGB procedures resulted in improved performance on different measures of auditory attention and both surgery groups improved across all processing speed tasks. Within the executive function domain, both groups showed improvements, but only the RYGB procedure resulted in improved performance in the Trail Making Test. Baseline auditory attention and memory performance predicted weight loss at 1 year following RYGB but not VSG surgery. Controlling for baseline cognitive performance, percent total weight loss predicted auditory attention at 1 year following RYGB but not VSG surgery. CONCLUSIONS Bariatric surgery type may result in selective improvements in cognition during the first year following surgery. Presurgical cognitive performance as well as surgery type appears to influence weight loss outcomes.
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Affiliation(s)
- Kimberly R Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA.
| | - Kimberley E Steele
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Afroditi Papantoni
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Civonnia Harris
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Caroline L Speck
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
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14
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Dietze LMF, McWhinney SR, Radua J, Hajek T. Extended and replicated white matter changes in obesity: Voxel-based and region of interest meta-analyses of diffusion tensor imaging studies. Front Nutr 2023; 10:1108360. [PMID: 36960197 PMCID: PMC10028081 DOI: 10.3389/fnut.2023.1108360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/03/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Obesity has become a global public health issue, which impacts general health and the brain. Associations between obesity and white matter microstructure measured using diffusion tensor imaging have been under reviewed, despite a relatively large number of individual studies. Our objective was to determine the association between obesity and white matter microstructure in a large general population sample. Methods We analyzed location of brain white matter changes in obesity using the Anisotropic Effect Size Seed-based d Mapping (AES-SDM) method in a voxel-based meta-analysis, with validation in a region of interest (ROI) effect size meta-analysis. Our sample included 21 742 individuals from 51 studies. Results The voxel-based spatial meta-analysis demonstrated reduced fractional anisotropy (FA) with obesity in the genu and splenium of the corpus callosum, middle cerebellar peduncles, anterior thalamic radiation, cortico-spinal projections, and cerebellum. The ROI effect size meta-analysis replicated associations between obesity and lower FA in the genu and splenium of the corpus callosum, middle cerebellar peduncles. Effect size of obesity related brain changes was small to medium. Discussion Our findings demonstrate obesity related brain white matter changes are localized rather than diffuse. Better understanding the brain correlates of obesity could help identify risk factors, and targets for prevention or treatment of brain changes.
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Affiliation(s)
- Lorielle M. F. Dietze
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | | | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- Department of Clinical Neuroscience, Center for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- National Institute of Mental Health, Prague, Czechia
- *Correspondence: Tomas Hajek,
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15
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Abstract
Most societies witness an ever increasing prevalence of both obesity and dementia, a scenario related to often underestimated individual and public health burden. Overnutrition and weight gain have been linked with abnormal functionality of homoeostasis brain networks and changes in higher cognitive functions such as reward evaluation, executive functions and learning and memory. In parallel, evidence has accumulated that modifiable factors such as obesity and diet impact the gut-brain axis and modulate brain health and cognition through various pathways. Using neuroimaging data from epidemiological studies and randomised clinical trials, we aim to shed light on the underlying mechanisms and to determine both determinants and consequences of obesity and diet at the level of human brain structure and function. We analysed multimodal 3T MRI of about 2600 randomly selected adults (47 % female, 18-80 years of age, BMI 18-47 kg/m2) of the LIFE-Adult study, a deeply phenotyped population-based cohort. In addition, brain MRI data of controlled intervention studies on weight loss and healthy diets acquired in lean, overweight and obese participants may help to understand the role of the gut-brain axis in food craving and cognitive ageing. We find that higher BMI and visceral fat accumulation correlate with accelerated brain age, microstructure of the hypothalamus, lower thickness and connectivity in default mode- and reward-related areas, as well as with subtle grey matter atrophy and white matter lesion load in non-demented individuals. Mediation analyses indicated that higher visceral fat affects brain tissue through systemic low-grade inflammation, and that obesity-related regional changes translate into cognitive disadvantages. Considering longitudinal studies, some, but not all data indicate beneficial effects of weight loss and healthy diets such as plant-based nutrients and dietary patterns on brain ageing and cognition. Confounding effects of concurrent changes in other lifestyle factors or false positives might help to explain these findings. Therefore a more holistic intervention approach, along with open science tools such as data and code sharing, in-depth pre-registration and pooling of data could help to overcome these limitations. In addition, as higher BMI relates to increased head micro-movements during MRI, and as head motion in turn systematically induces image artefacts, future studies need to rigorously control for head motion during MRI to enable valid neuroimaging results. In sum, our results support the view that overweight and obesity are intertwined with markers of brain health in the general population, and that weight loss and plant-based diets may help to promote brain plasticity. Meta-analyses and longitudinal cohort studies are underway to further differentiate causation from correlation in obesity- and nutrition-brain research.
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16
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Hidese S, Ota M, Matsuo J, Ishida I, Yokota Y, Hattori K, Yomogida Y, Kunugi H. Association of body mass index and its classifications with gray matter volume in individuals with a wide range of body mass index group: A whole-brain magnetic resonance imaging study. Front Hum Neurosci 2022; 16:926804. [PMID: 36158620 PMCID: PMC9493114 DOI: 10.3389/fnhum.2022.926804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Aim To examine the association of body mass index (BMI) [kg/m2] and its classifications (underweight [BMI < 18.5], normal [18.5 ≤ BMI < 25], overweight [25 ≤ BMI < 30], and obese [BMI ≥ 30]) with brain structure in individuals with a wide range of BMI group. Materials and methods The participants included 382 right-handed individuals (mean age: 46.9 ± 14.3 years, 142 men and 240 women). The intelligence quotient was assessed using the Japanese Adult Reading Test. Voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) were performed to analyze the association of BMI and its classifications with gray and white matter structures, respectively. Results According to VBM, BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes. In group comparisons, the right cerebellum exterior volume was significantly lower in the overweight or obese group than in the underweight or normal group, while the bilateral cuneus and calcarine cortex, left cuneus, and left precuneus volume was significantly lower in the underweight group than in the non-underweight group. Sex-related stratification analyses for VBM revealed that BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes only in women. In group comparisons, the left cerebellum exterior volume was significantly lower in obese women than in non-obese women. The left thalamus proper and the right cerebellum exterior volumes were significantly lower in overweight or obese group than in underweight or normal group in men and women, respectively. The bilateral cuneus and calcarine cortex, left cuneus and carcarine cortex, and bilateral cuneus volume was significantly lower in underweight men than in non-underweight men. In contrast, there were no notable findings on DTI. Conclusion Our results suggest association of continuous BMI, being overweight or obese, and being underweight with decreased gray matter volume in individuals with a wide range of BMI group. Furthermore, sex-related differences are seen in the association of BMI and its classifications with regional gray matter volume reductions. Abnormally high or low BMIs may have a negative influence on regional gray matter volumes.
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Japan
- *Correspondence: Shinsuke Hidese,
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Neuropsychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Japan
| | - Yuuki Yokota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Medical Genome Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yukihito Yomogida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Araya Inc., Minato-ku, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Japan
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17
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Woo A, Botta A, Shi SSW, Paus T, Pausova Z. Obesity-Related Neuroinflammation: Magnetic Resonance and Microscopy Imaging of the Brain. Int J Mol Sci 2022; 23:8790. [PMID: 35955925 PMCID: PMC9368789 DOI: 10.3390/ijms23158790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 12/01/2022] Open
Abstract
Obesity is a major risk factor of Alzheimer's disease and related dementias. The principal feature of dementia is a loss of neurons and brain atrophy. The mechanistic links between obesity and the neurodegenerative processes of dementias are not fully understood, but recent research suggests that obesity-related systemic inflammation and subsequent neuroinflammation may be involved. Adipose tissues release multiple proinflammatory molecules (fatty acids and cytokines) that impact blood and vessel cells, inducing low-grade systemic inflammation that can transition to tissues, including the brain. Inflammation in the brain-neuroinflammation-is one of key elements of the pathobiology of neurodegenerative disorders; it is characterized by the activation of microglia, the resident immune cells in the brain, and by the structural and functional changes of other cells forming the brain parenchyma, including neurons. Such cellular changes have been shown in animal models with direct methods, such as confocal microscopy. In humans, cellular changes are less tangible, as only indirect methods such as magnetic resonance (MR) imaging are usually used. In these studies, obesity and low-grade systemic inflammation have been associated with lower volumes of the cerebral gray matter, cortex, and hippocampus, as well as altered tissue MR properties (suggesting microstructural variations in cellular and molecular composition). How these structural variations in the human brain observed using MR imaging relate to the cellular variations in the animal brain seen with microscopy is not well understood. This review describes the current understanding of neuroinflammation in the context of obesity-induced systemic inflammation, and it highlights need for the bridge between animal microscopy and human MR imaging studies.
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Affiliation(s)
- Anita Woo
- The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
- Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Amy Botta
- The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
- Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Sammy S. W. Shi
- The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
- Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Tomas Paus
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC H3T 1C5, Canada
- Departments of Psychiatry of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- ECOGENE-21, Chicoutimi, QC G7H 7K9, Canada
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
- Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada
- ECOGENE-21, Chicoutimi, QC G7H 7K9, Canada
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18
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García-García I, Michaud A, Jurado MÁ, Dagher A, Morys F. Mechanisms linking obesity and its metabolic comorbidities with cerebral grey and white matter changes. Rev Endocr Metab Disord 2022; 23:833-843. [PMID: 35059979 DOI: 10.1007/s11154-021-09706-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 02/07/2023]
Abstract
Obesity is a preventable risk factor for cerebrovascular disorders and it is associated with cerebral grey and white matter changes. Specifically, individuals with obesity show diminished grey matter volume and thickness, which seems to be more prominent among fronto-temporal regions in the brain. At the same time, obesity is associated with lower microstructural white matter integrity, and it has been found to precede increases in white matter hyperintensity load. To date, however, it is unclear whether these findings can be attributed solely to obesity or whether they are a consequence of cardiometabolic complications that often co-exist with obesity, such as low-grade systemic inflammation, hypertension, insulin resistance, or dyslipidemia. In this narrative review we aim to provide a comprehensive overview of the potential impact of obesity and a number of its cardiometabolic consequences on brain integrity, both separately and in synergy with each other. We also identify current gaps in knowledge and outline recommendations for future research.
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Affiliation(s)
- Isabel García-García
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.
| | | | - María Ángeles Jurado
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Alain Dagher
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Filip Morys
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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19
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Hofmann SM, Beyer F, Lapuschkin S, Goltermann O, Loeffler M, Müller KR, Villringer A, Samek W, Witte AV. Towards the Interpretability of Deep Learning Models for Multi-modal Neuroimaging: Finding Structural Changes of the Ageing Brain. Neuroimage 2022; 261:119504. [PMID: 35882272 DOI: 10.1016/j.neuroimage.2022.119504] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
Brain-age (BA) estimates based on deep learning are increasingly used as neuroimaging biomarker for brain health; however, the underlying neural features have remained unclear. We combined ensembles of convolutional neural networks with Layer-wise Relevance Propagation (LRP) to detect which brain features contribute to BA. Trained on magnetic resonance imaging (MRI) data of a population-based study (n=2637, 18-82 years), our models estimated age accurately based on single and multiple modalities, regionally restricted and whole-brain images (mean absolute errors 3.37-3.86 years). We find that BA estimates capture aging at both small and large-scale changes, revealing gross enlargements of ventricles and subarachnoid spaces, as well as white matter lesions, and atrophies that appear throughout the brain. Divergence from expected aging reflected cardiovascular risk factors and accelerated aging was more pronounced in the frontal lobe. Applying LRP, our study demonstrates how superior deep learning models detect brain-aging in healthy and at-risk individuals throughout adulthood.
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Affiliation(s)
- Simon M Hofmann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Department of Artificial Intelligence, Fraunhofer Institute Heinrich Hertz, 10587 Berlin, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - Frauke Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Sebastian Lapuschkin
- Department of Artificial Intelligence, Fraunhofer Institute Heinrich Hertz, 10587 Berlin, Germany
| | - Ole Goltermann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Max Planck School of Cognition, 04103 Leipzig, Germany; Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Klaus-Robert Müller
- Department of Electrical Engineering and Computer Science, Technical University Berlin, 10623 Berlin, Germany; Department of Artificial Intelligence, Korea University, 02841 Seoul, Korea (the Republic of); Brain Team, Google Research, 10117 Berlin, Germany; Max Planck Institute for Informatics, 66123 Saarbrücken, Germany; BIFOLD - Berlin Institute for the Foundations of Learning and Data, 10587 Berlin, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany; MindBrainBody Institute, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; Center for Stroke Research, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Wojciech Samek
- Department of Artificial Intelligence, Fraunhofer Institute Heinrich Hertz, 10587 Berlin, Germany; Department of Electrical Engineering and Computer Science, Technical University Berlin, 10623 Berlin, Germany; BIFOLD - Berlin Institute for the Foundations of Learning and Data, 10587 Berlin, Germany
| | - A Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany
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20
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Brichko R, Soldan A, Zhu Y, Wang MC, Faria A, Albert M, Pettigrew C. Age-Dependent Association Between Cognitive Reserve Proxy and Longitudinal White Matter Microstructure in Older Adults. Front Psychol 2022; 13:859826. [PMID: 35756247 PMCID: PMC9226781 DOI: 10.3389/fpsyg.2022.859826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/12/2022] [Indexed: 01/26/2023] Open
Abstract
Objective This study examined the association of lifetime experiences, measured by a cognitive reserve (CR) composite score composed of years of education, literacy, and vocabulary measures, to level and rate of change in white matter microstructure, as assessed by diffusion tensor imaging (DTI) measures. We also examined whether the relationship between the proxy CR composite score and white matter microstructure was modified by participant age, APOE-ε4 genetic status, and level of vascular risk. Methods A sample of 192 non-demented (n = 166 cognitively normal, n = 26 mild cognitive impairment) older adults [mean age = 70.17 (SD = 8.5) years] from the BIOCARD study underwent longitudinal DTI (mean follow-up = 2.5 years, max = 4.7 years). White matter microstructure was quantified by fractional anisotropy (FA) and radial diffusivity (RD) values in global white matter tracts and medial temporal lobe (MTL) white matter tracts. Results Using longitudinal linear mixed effect models, we found that FA decreased over time and RD increased over time in both the global and MTL DTI composites, but the rate of change in these DTI measures was not related to level of CR. However, there were significant interactions between the CR composite score and age for global RD in the full sample, and for global FA, global RD, and MTL RD among those with normal cognition. These interactions indicated that among participants with a lower baseline age, higher CR composite scores were associated with higher FA and lower RD values, while among participants with higher age at baseline, higher CR composite scores were associated with lower FA and higher RD values. Furthermore, these relationships were not modified by APOE-ε4 genotype or level of vascular risk. Conclusion The association between level of CR and DTI measures differs by age, suggesting a possible neuroprotective effect of CR among late middle-aged adults that shifts to a compensatory effect among older adults.
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Affiliation(s)
- Rostislav Brichko
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Anja Soldan
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Yuxin Zhu
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Mei-Cheng Wang
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Andreia Faria
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Marilyn Albert
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Corinne Pettigrew
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States,*Correspondence: Corinne Pettigrew,
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21
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Engel C, Wirkner K, Zeynalova S, Baber R, Binder H, Ceglarek U, Enzenbach C, Fuchs M, Hagendorff A, Henger S, Hinz A, Rauscher FG, Reusche M, Riedel-Heller SG, Röhr S, Sacher J, Sander C, Schroeter ML, Tarnok A, Treudler R, Villringer A, Wachter R, Witte AV, Thiery J, Scholz M, Loeffler M. Cohort Profile: The LIFE-Adult-Study. Int J Epidemiol 2022; 52:e66-e79. [PMID: 35640047 PMCID: PMC9908058 DOI: 10.1093/ije/dyac114] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/10/2022] [Indexed: 01/14/2023] Open
Affiliation(s)
- Christoph Engel
- Corresponding author. Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Haertelstrasse 16–18, 04107 Leipzig, Germany. E-mail:
| | | | | | - Ronny Baber
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Hans Binder
- Interdisciplinary Centre for Bioinformatics, Leipzig University, Leipzig, Germany
| | - Uta Ceglarek
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Cornelia Enzenbach
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Michael Fuchs
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany,Division Otolaryngology, Head and Neck Surgery, Phoniatrics and Audiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Hagendorff
- Department of Cardiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Sylvia Henger
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Matthias Reusche
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Medicine and Public Health (ISAP), Leipzig University, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Medicine and Public Health (ISAP), Leipzig University, Leipzig, Germany,Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Julia Sacher
- Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christian Sander
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany,Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Matthias L Schroeter
- Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Attila Tarnok
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany,Department of Preclinical Development and Validation, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Regina Treudler
- Department of Dermatology, Venerology and Allergology, University of Leipzig Medical Center, Leipzig, Germany,Leipzig Interdisciplinary Allergy Center (LICA)—Comprehensive Allergy Center, University of Leipzig Medical Center, Leipzig, Germany
| | - Arno Villringer
- Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Rolf Wachter
- Clinic and Policlinic for Cardiology, University of Leipzig Medical Center, Leipzig, Germany
| | - A Veronica Witte
- Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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22
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Liu Y, Tan SX, Wu YK, Shen YK, Zhang LJ, Kang M, Ying P, Pan YC, Shu HY, Shao Y. Altered Intrinsic Regional Spontaneous Brain Activity in Patients With Severe Obesity and Meibomian Gland Dysfunction: A Resting-State Functional Magnetic Resonance Imaging Study. Front Hum Neurosci 2022; 16:879513. [PMID: 35664349 PMCID: PMC9161641 DOI: 10.3389/fnhum.2022.879513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate potential regional homogeneity (ReHo) cerebrum function lesions in people with severe obesity and meibomian gland dysfunction (SM) and probe the connection between aberrant cerebrum activity and clinical manifestations. Patients and Methods An aggregation of 12 patients with SM, and 12 healthy controls (HCs) closely matched in age and gender were enrolled. We applied corneal confocal microscopy and fundus angiography to compare imaging distinctions between the two groups. SMs were required to carefully fill out the Hospital Anxiety Depression Scale (HADS) forms, and a correlation analysis was performed. ReHo was also utilized to appraise partial differences in spontaneous cerebrum function. Receiver operating characteristic (ROC) curves were created to partition ReHo values between patients with SM and the HCs. Results ReHo values for the left cerebellum (LC), right fusiform gyrus (RFG), left inferior temporal gyrus (LITG), left rectus gyrus (LRG), right thalamus (RT), right caudate (RC), left insula (LI), and left thalamus (LT) of subjects with SM were notably higher than those of the HCs (P < 0.05). ReHo values of the right middle frontal gyrus (RMFG) in subjects with SM were decreased notably compared to the HCs (P < 0.05). ReHo values for the RMFG showed a negative correlation with the anxiety scores (ASs; r = −0.961, P < 0.001) and ReHo values for the RFG showed a positive correlation with the depression scores (DSs; r = 0.676, P = 0.016). The areas under the ROC curve were 1.000 (P < 0.001) for the RMFG, LC, LITG, LRG, RC, LI, and LT and 0.993 (P < 0.001) for the RFG and RT. The results from the ROC curve analysis indicated that changes in the ReHo values of some brain regions may help diagnose SM. Conclusion Our research emphasized that patients with SM had lesions in synchronized neural activity in many encephalic areas. Our discoveries may provide beneficial information for exploring the neuromechanics of SM.
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Affiliation(s)
- Yi Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Sheng-Xing Tan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu-Kang Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan-Kun Shen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li-Juan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Ping Ying
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Yi-Cong Pan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Hui-Ye Shu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
- *Correspondence: Yi Shao,
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23
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Okudzhava L, Heldmann M, Münte TF. A systematic review of diffusion tensor imaging studies in obesity. Obes Rev 2022; 23:e13388. [PMID: 34908217 DOI: 10.1111/obr.13388] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 12/29/2022]
Abstract
Obesity is a major global health problem leading to serious complications. It has been consistently associated with alterations in brain structure. Diffusion tensor imaging is used to examine brain white matter microstructure by assessing the dynamics of water diffusion in white matter tracts. Fractional anisotropy and mean diffusivity are two parameters measuring the directionality and rate of diffusion, respectively. Changes in these indices associated with obesity have been previously reported in numerous fiber tracts. This systematic review investigates microstructural white matter alterations in obesity using diffusion tensor imaging. A computerized search was performed in PubMed, Web of Science, and Livivo databases. Based on the inclusion/exclusion criteria, 31 cross-sectional studies comparing individuals with obesity and lean controls were identified. The studies included mixed-gender samples of children, young, middle-aged, and older adults. The majority of included studies reported decreased fractional anisotropy and increased mean diffusivity associated with elevated body mass index, suggesting white matter abnormalities. Nevertheless, a pattern of alterations is inconsistent across studies. This could be explained by several potential biases assessed by the National Institute of Health quality assessment tool. Furthermore, a direct assessment of body fat is recommended for a more accurate characterization of the brain-body relationship.
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Affiliation(s)
- Liana Okudzhava
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Department of Psychology, University of Lübeck, Lübeck, Germany
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24
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Olsthoorn L, Vreeken D, Kiliaan AJ. Gut Microbiome, Inflammation, and Cerebrovascular Function: Link Between Obesity and Cognition. Front Neurosci 2021; 15:761456. [PMID: 34938153 PMCID: PMC8685335 DOI: 10.3389/fnins.2021.761456] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/16/2021] [Indexed: 12/13/2022] Open
Abstract
Obesity affects 13% of the adult population worldwide and this number is only expected to increase. Obesity is known to have a negative impact on cardiovascular and metabolic health, but it also impacts brain structure and function; it is associated with both gray and white matter integrity loss, as well as decreased cognitive function, including the domains of executive function, memory, inhibition, and language. Especially midlife obesity is associated with both cognitive impairment and an increased risk of developing dementia at later age. However, underlying mechanisms are not yet fully revealed. Here, we review recent literature (published between 2010 and March 2021) and discuss the effects of obesity on brain structure and cognition, with a main focus on the contributions of the gut microbiome, white adipose tissue (WAT), inflammation, and cerebrovascular function. Obesity-associated changes in gut microbiota composition may cause increased gut permeability and inflammation, therewith affecting cognitive function. Moreover, excess of WAT in obesity produces pro-inflammatory adipokines, leading to a low grade systemic peripheral inflammation, which is associated with decreased cognition. The blood-brain barrier also shows increased permeability, allowing among others, peripheral pro-inflammatory markers to access the brain, leading to neuroinflammation, especially in the hypothalamus, hippocampus and amygdala. Altogether, the interaction between the gut microbiota, WAT inflammation, and cerebrovascular integrity plays a significant role in the link between obesity and cognition. Future research should focus more on the interplay between gut microbiota, WAT, inflammation and cerebrovascular function to obtain a better understanding about the complex link between obesity and cognitive function in order to develop preventatives and personalized treatments.
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Affiliation(s)
- Lisette Olsthoorn
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, Netherlands
| | - Debby Vreeken
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, Netherlands.,Department of Bariatric Surgery, Vitalys, Rijnstate Hospital, Arnhem, Netherlands
| | - Amanda J Kiliaan
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, Netherlands
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25
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Same Brain, Different Look?-The Impact of Scanner, Sequence and Preprocessing on Diffusion Imaging Outcome Parameters. J Clin Med 2021; 10:jcm10214987. [PMID: 34768507 PMCID: PMC8584364 DOI: 10.3390/jcm10214987] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 11/17/2022] Open
Abstract
In clinical diagnostics and longitudinal studies, the reproducibility of MRI assessments is of high importance in order to detect pathological changes, but developments in MRI hard- and software often outrun extended periods of data acquisition and analysis. This could potentially introduce artefactual changes or mask pathological alterations. However, if and how changes of MRI hardware, scanning protocols or preprocessing software affect complex neuroimaging outcomes from, e.g., diffusion weighted imaging (DWI) remains largely understudied. We therefore compared DWI outcomes and artefact severity of 121 healthy participants (age range 19–54 years) who underwent two matched DWI protocols (Siemens product and Center for Magnetic Resonance Research sequence) at two sites (Siemens 3T Magnetom Verio and Skyrafit). After different preprocessing steps, fractional anisotropy (FA) and mean diffusivity (MD) maps, obtained by tensor fitting, were processed with tract-based spatial statistics (TBSS). Inter-scanner and inter-sequence variability of skeletonised FA values reached up to 5% and differed largely in magnitude and direction across the brain. Skeletonised MD values differed up to 14% between scanners. We here demonstrate that DTI outcome measures strongly depend on imaging site and software, and that these biases vary between brain regions. These regionally inhomogeneous biases may exceed and considerably confound physiological effects such as ageing, highlighting the need to harmonise data acquisition and analysis. Future studies thus need to implement novel strategies to augment neuroimaging data reliability and replicability.
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26
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Morys F, Dadar M, Dagher A. Association Between Midlife Obesity and Its Metabolic Consequences, Cerebrovascular Disease, and Cognitive Decline. J Clin Endocrinol Metab 2021; 106:e4260-e4274. [PMID: 33677592 PMCID: PMC8475210 DOI: 10.1210/clinem/dgab135] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Indexed: 01/08/2023]
Abstract
CONTEXT Chronic obesity is associated with several complications, including cognitive impairment and dementia. However, we have only piecemeal knowledge of the mechanisms linking obesity to central nervous system damage. Among candidate mechanisms are other elements of obesity-associated metabolic syndrome, such as hypertension, dyslipidemia, and diabetes, but also systemic inflammation. While there have been several neuroimaging studies linking adiposity to changes in brain morphometry, a comprehensive investigation of the relationship has so far not been done. OBJECTIVE To identify links between adiposity and cognitive dysfunction. METHODS This observational cohort study (UK Biobank), with an 8-year follow-up, included more than 20 000 participants from the general community, with a mean age of 63 years. Only participants with data available on both baseline and follow-up timepoints were included. The main outcome measures were cognitive performance and mediator variables: hypertension, diabetes, systemic inflammation, dyslipidemia, gray matter measures, and cerebrovascular disease (volume of white matter hyperintensities on magnetic resonance imaging). RESULTS Using structural equation modeling, we found that body mass index, waist-to-hip ratio, and body fat percentage were positively related to higher plasma C-reactive protein, dyslipidemia, hypertension, and diabetes. In turn, hypertension and diabetes were related to cerebrovascular disease. Finally, cerebrovascular disease was associated with lower cortical thickness and volume and higher subcortical volumes, but also cognitive deficits (largest significant pcorrected = 0.02). CONCLUSIONS We show that adiposity is related to poor cognition, with metabolic consequences of obesity and cerebrovascular disease as potential mediators. The outcomes have clinical implications, supporting a role for the management of adiposity in the prevention of late-life dementia and cognitive decline.
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Affiliation(s)
- Filip Morys
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
- Correspondence: Filip Morys, Ph.D., Université McGill, 3801 University Street, H3A 2B4 Montreal, Canada.
| | - Mahsa Dadar
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Québec, Canada
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
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27
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Ingo C, Kurian S, Higgins J, Mahinrad S, Jenkins L, Gorelick P, Lloyd-Jones D, Sorond F. Vascular health and diffusion properties of normal appearing white matter in midlife. Brain Commun 2021; 3:fcab080. [PMID: 34494002 DOI: 10.1093/braincomms/fcab080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 01/20/2023] Open
Abstract
In this study, we perform a region of interest diffusion tensor imaging and advanced diffusion complexity analysis of normal appearing white matter to determine the impact of vascular health on these diffusivity metrics in midlife adults. 77 participants (26 black, 35 female) at year 30 visit in the Coronary Artery Risk Development in Young Adults longitudinal study were scanned with an advanced diffusion-weighted imaging and fluid-attenuated inversion recovery protocol. Fractional anisotropy and non-linear diffusion complexity measures were estimated. Cumulative measures across 30 years (9 study visits) of systolic blood pressure, body mass index, glucose, smoking and cholesterol were calculated as the area under the curve from baseline up to year 30 examination. Partial correlation analyses assessed the association between cumulative vascular health measures and normal appearing white matter diffusion metrics in these participants. Midlife normal appearing white matter diffusion properties were significantly associated (P < 0.05) with cumulative exposure to vascular risk factors from young adulthood over the 30-year time period. Higher cumulative systolic blood pressure exposure was associated with increased complexity and decreased fractional anisotropy. Higher cumulative body mass index exposure was associated with decreased fractional anisotropy. Additionally, in the normal appearing white matter of black participants (P < 0.05), who exhibited a higher cumulative vascular risk exposure, fractional anisotropy was lower and complexity was higher in comparison to normal appearing white matter in white participants. Higher burden of vascular risk factor exposure from young adulthood to midlife is associated with changes in the diffusion properties of normal appearing white matter in midlife. These changes which may reflect axonal disruption, increased inflammation and/or increased glial proliferation, were primarily observed in both anterior and posterior normal appearing white matter regions of the corpus callosum. These results suggest that microstructural changes in normal appearing white matter are sensitive to vascular health during young adulthood and are possibly therapeutic targets in interventions focused on preserving white matter health across life.
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Affiliation(s)
- Carson Ingo
- Department of Neurology, Northwestern University, Chicago, IL, USA.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Shawn Kurian
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - James Higgins
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Simin Mahinrad
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Lisanne Jenkins
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Philip Gorelick
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Farzaneh Sorond
- Department of Neurology, Northwestern University, Chicago, IL, USA
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28
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Ottino-González J, Baggio HC, Jurado MÁ, Segura B, Caldú X, Prats-Soteras X, Tor E, Sender-Palacios MJ, Miró N, Sánchez-Garre C, Dadar M, Dagher A, García-García I, Garolera M. Alterations in Brain Network Organization in Adults With Obesity as Compared With Healthy-Weight Individuals and Seniors. Psychosom Med 2021; 83:700-706. [PMID: 33938505 DOI: 10.1097/psy.0000000000000952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Life expectancy and obesity rates have drastically increased in recent years. An unhealthy weight is related to long-lasting medical disorders that might compromise the normal course of aging. The aim of the current study of brain connectivity patterns was to examine whether adults with obesity would show signs of premature aging, such as lower segregation, in large-scale networks. METHODS Participants with obesity (n = 30, mean age = 32.8 ± 5.68 years) were compared with healthy-weight controls (n = 33, mean age = 30.9 ± 6.24 years) and senior participants who were stroke-free and without dementia (n = 30, mean age = 67.1 ± 6.65 years) using resting-state magnetic resonance imaging and graph theory metrics (i.e., small-world index, clustering coefficient, characteristic path length, and degree). RESULTS Contrary to our hypothesis, participants with obesity exhibited a higher clustering coefficient compared with senior participants (t = 5.06, p < .001, d = 1.23, 95% CIbca = 0.64 to 1.88). Participants with obesity also showed lower global degree relative to seniors (t = -2.98, p = .014, d = -0.77, 95% CIbca = -1.26 to -0.26) and healthy-weight controls (t = -2.92, p = .019, d = -0.72, 95% CIbca = -1.19 to -0.25). Regional degree alterations in this group were present in several functional networks. CONCLUSIONS Participants with obesity displayed greater network clustering than did seniors and also had lower degree compared with seniors and individuals with normal weight, which is not consistent with the notion that obesity is associated with premature aging of the brain. Although the cross-sectional nature of the study precludes causal inference, the overly clustered network patterns in obese participants could be relevant to age-related changes in brain function because regular networks might be less resilient and metabolically inefficient.
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Affiliation(s)
- Jonatan Ottino-González
- From the Department of Psychiatry (González), University of Vermont College of Medicine, Burlington; Departament de Psicologia Clínica i Psicobiologia (Jurado, Caldú, Prats-Soteras, García-García) and Institut de Neurociències (Baggio, Jurado, Segura, Caldú, Prats-Soteras, García-García), Universitat de Barcelona; Institut de Recerca Sant Joan de Dèu (Ottino-González, Jurado, Caldú, Prats-Soteras, García-García), Hospital Sant Joan de Dèu; Departament de Medicina (Baggio, Segura), Universitat de Barcelona, Barcelona; Montreal Neurological Institute (Dadar, Dagher), McGill University, Montreal, Canada; Unitat d'Endocrinologia, Hospital de Terrassa (Miró, Sánchez-Garre), Consorci Sanitari de Terrassa; and CAP Terrassa Nord (Tor, Sender-Palacios), Unitat de Neuropsicologia, Hospital de Terrassa (Garolera), and Brain, Cognition and Behaviour Research Group (Garolera), Consorci Sanitari de Terrassa, Spain
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29
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Iceta S, Panahi S, García-García I, Michaud A. The Impact of Restrictive and Non-restrictive Dietary Weight Loss Interventions on Neurobehavioral Factors Related to Body Weight Control: the Gaps and Challenges. Curr Obes Rep 2021; 10:385-395. [PMID: 34318394 DOI: 10.1007/s13679-021-00452-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Restrictive diets, such as low-calorie diets, are difficult to maintain in the long term. For this reason, their popularity has decreased compared to non-restrictive approaches, which instead promote healthy eating strategies. Since both strategies may entail different neurobiological mechanisms, this review will examine the current evidence on the effects of restrictive and non-restrictive interventions on neurobehavioral factors. RECENT FINDINGS Restrictive diets appear to improve eating behaviors, and the evidence reviewed argues against the notion that they may worsen the severity of binge eating. Moreover, they may lead to short-term changes in brain structure and improvements in cerebrovascular markers which, in turn, could impact eating behaviors. Non-restrictive interventions may have a positive effect on weight management and eating behaviors. However, evidence of their neural effects is scarce. Small sample sizes, short follow-ups, and the absence of control groups are limitations of the studies targeting both interventions. Rigorous long-term randomized studies are needed to examine the neurobehavioral effects of restrictive and non-restrictive approaches.
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Affiliation(s)
- Sylvain Iceta
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada
| | - Shirin Panahi
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- Faculty of Educational Sciences, Department of Physical Education, Université Laval, Québec, QC, G1V OA6, Canada
- Faculty of Medicine, Department of Kinesiology, Université Laval, Québec, QC, G1V OA6, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035, Barcelona, Spain
| | - Andréanne Michaud
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada.
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada.
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada.
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Zeighami Y, Iceta S, Dadar M, Pelletier M, Nadeau M, Biertho L, Lafortune A, Tchernof A, Fulton S, Evans A, Richard D, Dagher A, Michaud A. Spontaneous neural activity changes after bariatric surgery: A resting-state fMRI study. Neuroimage 2021; 241:118419. [PMID: 34302967 DOI: 10.1016/j.neuroimage.2021.118419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Metabolic disorders associated with obesity could lead to alterations in brain structure and function. Whether these changes can be reversed after weight loss is unclear. Bariatric surgery provides a unique opportunity to address these questions because it induces marked weight loss and metabolic improvements which in turn may impact the brain in a longitudinal fashion. Previous studies found widespread changes in grey matter (GM) and white matter (WM) after bariatric surgery. However, findings regarding changes in spontaneous neural activity following surgery, as assessed with the fractional amplitude of low frequency fluctuations (fALFF) and regional homogeneity of neural activity (ReHo), are scarce and heterogenous. In this study, we used a longitudinal design to examine the changes in spontaneous neural activity after bariatric surgery (comparing pre- to post-surgery), and to determine whether these changes are related to cardiometabolic variables. METHODS The study included 57 participants with severe obesity (mean BMI=43.1 ± 4.3 kg/m2) who underwent sleeve gastrectomy (SG), biliopancreatic diversion with duodenal switch (BPD), or Roux-en-Y gastric bypass (RYGB), scanned prior to bariatric surgery and at follow-up visits of 4 months (N = 36), 12 months (N = 29), and 24 months (N = 14) after surgery. We examined fALFF and ReHo measures across 1022 cortical and subcortical regions (based on combined Schaeffer-Xiao parcellations) using a linear mixed effect model. Voxel-based morphometry (VBM) based on T1-weighted images was also used to measure GM density in the same regions. We also used an independent sample from the Human Connectome Project (HCP) to assess regional differences between individuals who had normal-weight (N = 46) or severe obesity (N = 46). RESULTS We found a global increase in the fALFF signal with greater increase within dorsolateral prefrontal cortex, precuneus, inferior temporal gyrus, and visual cortex. This effect was more significant 4 months after surgery. The increase within dorsolateral prefrontal cortex, temporal gyrus, and visual cortex was more limited after 12 months and only present in the visual cortex after 24 months. These increases in neural activity measured by fALFF were also significantly associated with the increase in GM density following surgery. Furthermore, the increase in neural activity was significantly related to post-surgery weight loss and improvement in cardiometabolic variables, such as blood pressure. In the independent HCP sample, normal-weight participants had higher global and regional fALFF signals, mainly in dorsolateral/medial frontal cortex, precuneus and middle/inferior temporal gyrus compared to the obese participants. These BMI-related differences in fALFF were associated with the increase in fALFF 4 months post-surgery especially in regions involved in control, default mode and dorsal attention networks. CONCLUSIONS Bariatric surgery-induced weight loss and improvement in metabolic factors are associated with widespread global and regional increases in neural activity, as measured by fALFF signal. These findings alongside the higher fALFF signal in normal-weight participants compared to participants with severe obesity in an independent dataset suggest an early recovery in the neural activity signal level after the surgery.
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Affiliation(s)
- Yashar Zeighami
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada; Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
| | - Sylvain Iceta
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Mahsa Dadar
- CERVO Brain Research Center, Centre intégré universitaire santé et services sociaux de la Capitale Nationale, Université Laval, Québec, Canada
| | - Mélissa Pelletier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Mélanie Nadeau
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Laurent Biertho
- Département de chirurgie générale, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Annie Lafortune
- Département de chirurgie générale, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - André Tchernof
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Stephanie Fulton
- Centre de Recherche du CHUM and Montreal Diabetes Research Center, Montreal, QC, Canada
| | - Alan Evans
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada; Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
| | - Denis Richard
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Alain Dagher
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Andréanne Michaud
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada.
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Daoust J, Schaffer J, Zeighami Y, Dagher A, García-García I, Michaud A. White matter integrity differences in obesity: A meta-analysis of diffusion tensor imaging studies. Neurosci Biobehav Rev 2021; 129:133-141. [PMID: 34284063 DOI: 10.1016/j.neubiorev.2021.07.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/07/2021] [Accepted: 07/15/2021] [Indexed: 01/17/2023]
Abstract
Some Diffusion Tensor Imaging studies have shown a loss of white matter (WM) integrity linked to impaired cognitive function in obese individuals. However, inconsistent WM integrity changes have been reported. We aimed to identify which WM tracts show consistent changes with obesity. We conducted a systematic search to find studies examining the association between obesity-related measures and Fractional Anisotropy (FA) or Mean Diffusivity. We performed a meta-analysis with FA datasets using Anisotropic Effect Size-Signed Differential Mapping software. The meta-analysis showed that increased obesity measurements were related to reduced FA in the genu of the corpus callosum. We validated our findings using an independent sample from the Human Connectome Project dataset, which supports lower FA in this region in individuals with obesity compared to those with normal weight (p = 0.028). Our findings provide evidence that obesity is associated with reduced WM integrity in the genu of the corpus callosum, a tract linking frontal areas involved in executive function. Future studies are needed on the mechanisms linking obesity with loss of WM integrity.
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Affiliation(s)
- Justine Daoust
- Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 chemin Sainte-Foy, Québec, Québec, G1V 4G5, Canada; School of Nutrition, Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Joelle Schaffer
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Yashar Zeighami
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Alain Dagher
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Gran Via de les Corts Catalanes, 585, 08007, Barcelona, Spain
| | - Andréanne Michaud
- Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 chemin Sainte-Foy, Québec, Québec, G1V 4G5, Canada; School of Nutrition, Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada.
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Iriondo A, García-Sebastian M, Arrospide A, Arriba M, Aurtenetxe S, Barandiaran M, Clerigue M, Ecay-Torres M, Estanga A, Gabilondo A, Izagirre A, Saldias J, Tainta M, Villanua J, Mar J, Goñi FM, Martínez-Lage P. Plasma lipids are associated with white matter microstructural changes and axonal degeneration. Brain Imaging Behav 2021; 15:1043-1057. [PMID: 32748320 DOI: 10.1007/s11682-020-00311-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Dislipidemia is a risk factor for cognitive impairment. We studied the association between interindividual variability of plasma lipids and white matter (WM) microstructure, using diffusion tensor imaging (DTI) in 273 healthy adults. Special focus was placed on 7 regions of interest (ROI) which are structural components of cognitive neurocircuitry. We also investigated the effect of plasma lipids on cerebrospinal fluid (CSF) neurofilament light chain (NfL), an axonal degeneration marker. Low density lipoprotein (LDL) and triglyceride (TG) levels showed a negative association with axial diffusivity (AxD) in multiple regions. High density lipoproteins (HDL) showed a positive correlation. The association was independent of Apolipoprotein E (APOE) genotype, blood pressure or use of statins. LDL moderated the relation between NfL and AxD in the body of the corpus callosum (p = 0.041), right cingulum gyrus (p = 0.041), right fornix/stria terminalis (p = 0.025) and right superior longitudinal fasciculus (p = 0.020) and TG in the right inferior longitudinal fasciculus (p = 0.004) and left fornix/stria terminalis (p = 0.001). We conclude that plasma lipids are associated to WM microstructural changes and axonal degeneration and might represent a risk factor in the transition from healthy aging to disease.
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Affiliation(s)
- Ane Iriondo
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Maite García-Sebastian
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Arantzazu Arrospide
- Gipuzkoa Primary Care - Integrated Health Care Organizations Research Unit. Alto Deba Integrated Health Care Organisation, Arrasate, Spain.,Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Maria Arriba
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Sara Aurtenetxe
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Myriam Barandiaran
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Montserrat Clerigue
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Mirian Ecay-Torres
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Ainara Estanga
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Alazne Gabilondo
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Andrea Izagirre
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain.,Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jon Saldias
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Mikel Tainta
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Jorge Villanua
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Javier Mar
- Gipuzkoa Primary Care - Integrated Health Care Organizations Research Unit. Alto Deba Integrated Health Care Organisation, Arrasate, Spain.,Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Felix M Goñi
- Departamento de Bioquímica, University of the Basque Country (UPV/EHU) and Instituto Biofisika (CSIC, UPV/EHU), Leioa, Spain
| | - Pablo Martínez-Lage
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain.
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Cannavale CN, Bailey M, Edwards CG, Thompson SV, Walk AM, Burd NA, Holscher HD, Khan NA. Systemic inflammation mediates the negative relationship between visceral adiposity and cognitive control. Int J Psychophysiol 2021; 165:68-75. [PMID: 33839195 DOI: 10.1016/j.ijpsycho.2021.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 01/22/2023]
Abstract
Elevated visceral adipose tissue (VAT) has been associated with cardiometabolic risk factors including chronic systemic low-grade inflammation. Whereas the cognitive implications of inflammation have been extensively studied in preclinical models, the influence of inflammatory cytokines on cognitive function in humans is unclear. This study aimed to investigate the relations among VAT, inflammatory cytokines, and cognitive control. We hypothesized that inflammatory markers would mediate the negative influence of VAT on selective attention. Participants between 25 and 46 years (N = 115, 43 females) underwent a DXA scan to estimate VAT. A modified Eriksen Flanker task was used to assess attentional inhibitory control while event-related potentials were recorded. ELISA was used to quantify plasma C-reactive protein (CRP) and Interleukin-6 (IL-6) concentrations. Mediation modeling while controlling for diet quality and education level revealed that CRP concentrations significantly mediated the relationship between VAT and incongruent trial accuracy (indirect effect 95% CI {-0.24, -0.01}). Further, IL-6 concentrations had a significant mediation effect on the relationship between VAT and incongruent P3 peak latency (indirect effect 95% CI {0.05, 1.39}). These results suggest that mechanisms by which visceral adiposity exerts a negative influence on cognitive function includes systemic inflammation.
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Affiliation(s)
- Corinne N Cannavale
- Neuroscience Program, University of Illinois at Urbana-Champaign, United States of America
| | - Melisa Bailey
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, United States of America
| | - Caitlyn G Edwards
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, United States of America
| | - Sharon V Thompson
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, United States of America
| | - Anne M Walk
- Department of Psychology, Eastern Illinois University, United States of America
| | - Nicholas A Burd
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, United States of America; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States of America
| | - Hannah D Holscher
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, United States of America; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States of America; Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, United States of America
| | - Naiman A Khan
- Neuroscience Program, University of Illinois at Urbana-Champaign, United States of America; Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, United States of America; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States of America.
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Should context hold a special place in hippocampal memory? PSYCHOLOGY OF LEARNING AND MOTIVATION 2021. [DOI: 10.1016/bs.plm.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Witte V. Adipositas und Gehirngesundheit. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-020-00483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Liu Y, Han J, Ning L, Chen L, Jiang X, Ke A, Zhang Y. Cognitive function and life quality of patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome in China. Expert Rev Respir Med 2020; 15:435-440. [PMID: 33315466 DOI: 10.1080/17476348.2021.1852081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To investigate the correlation between cognitive function and quality of life in patients with moderate to severe OSAHS, and to further analyze the impact of cognitive domains on QoL in patients with OSAHS.Methods: Pearson analysis was applied to explore the correlation between MoCA score and SAQLI score. It was conducted by collecting the clinical characteristics of patients and the Epworth Sleepiness Scale and Sleep Quality Scale. T-test, a non-parametric test (Mann-Whitney) or chi-square test, and Pearson analysis were used to analyze the relationship between MoCA score and patient clinical characteristics, sleep variables, and SAQLI score.Results: The SAQLI score of the MCI group significantly decreased. Patients in the MCI group had a higher WHR, higher alcohol intake, and a history of hypertension were firmly related to the poor SAQLI (P < 0.05). The Epworth sleepiness scale (ESS) score increased in the MCI group, and the AHI and ODI elevated significantly, which was related to the poorer SAQLI as well (P < 0.05).Conclusion: Cognitive impairment in OSAHS patients is related to QoL reduction.Keywords: cognitive function; Montreal cognitive assessment; obstructive sleep apnea hypopnea syndrome; quality of life; sleep apnea quality of life index.
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Affiliation(s)
- YeHai Liu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - JiangYin Han
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Lin Ning
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - LiJuan Chen
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Xiao Jiang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - AnRan Ke
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - YinHua Zhang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
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Alqarni A, Jiang J, Crawford JD, Koch F, Brodaty H, Sachdev P, Wen W. Sex differences in risk factors for white matter hyperintensities in non-demented older individuals. Neurobiol Aging 2020; 98:197-204. [PMID: 33307330 DOI: 10.1016/j.neurobiolaging.2020.11.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 02/07/2023]
Abstract
White matter hyperintensities (WMH) are generally considered to be associated with cerebral small vessel disease, especially, in older age. Although significant sex differences have been reported in the severity of WMH, it is not yet known if the risk factors for WMH differ in men and women. In this study, magnetic resonance imaging brain scans from 2 Australian cohorts were analyzed to extract WMH volumes. The objective of this study is to examine the moderation effect by sex in the association between known risk factors and WMH. The burden of WMH was significantly higher in women compared to men, especially in the deep WMH (DWMH). In the generalized linear model that included the interaction between sex and body mass index (BMI), there was a differential association of BMI with DWMH in men and women in the exploratory sample, that is, the Sydney Memory and Aging Study, n = 432, aged between 70 and 90. The finding of a higher BMI associated with a higher DWMH in men compared to women was replicated in the Older Australian Twins Study sample, n = 179, aged between 65 and 90. The risk factors of WMH pathology are suggested to have a different impact on the aging brains of men and women.
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Affiliation(s)
- Abdullah Alqarni
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Forrest Koch
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Higher BMI, but not obesity-related genetic polymorphisms, correlates with lower structural connectivity of the reward network in a population-based study. Int J Obes (Lond) 2020; 45:491-501. [PMID: 33100325 PMCID: PMC7906899 DOI: 10.1038/s41366-020-00702-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/13/2020] [Accepted: 10/14/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity is of complex origin, involving genetic and neurobehavioral factors. Genetic polymorphisms may increase the risk for developing obesity by modulating dopamine-dependent behaviors, such as reward processing. Yet, few studies have investigated the association of obesity, related genetic variants, and structural connectivity of the dopaminergic reward network. METHODS We analyzed 347 participants (age range: 20-59 years, BMI range: 17-38 kg/m2) of the LIFE-Adult Study. Genotyping for the single nucleotid polymorphisms rs1558902 (FTO) and rs1800497 (near dopamine D2 receptor) was performed on a microarray. Structural connectivity of the reward network was derived from diffusion-weighted magnetic resonance imaging at 3 T using deterministic tractography of Freesurfer-derived regions of interest. Using graph metrics, we extracted summary measures of clustering coefficient and connectivity strength between frontal and striatal brain regions. We used linear models to test the association of BMI, risk alleles of both variants, and reward network connectivity. RESULTS Higher BMI was significantly associated with lower connectivity strength for number of streamlines (β = -0.0025, 95%-C.I.: [-0.004, -0.0008], p = 0.0042), and, to lesser degree, fractional anisotropy (β = -0.0009, 95%-C.I. [-0.0016, -0.00008], p = 0.031), but not clustering coefficient. Strongest associations were found for left putamen, right accumbens, and right lateral orbitofrontal cortex. As expected, the polymorphism rs1558902 in FTO was associated with higher BMI (F = 6.9, p < 0.001). None of the genetic variants was associated with reward network structural connectivity. CONCLUSIONS Here, we provide evidence that higher BMI correlates with lower reward network structural connectivity. This result is in line with previous findings of obesity-related decline in white matter microstructure. We did not observe an association of variants in FTO or near DRD2 receptor with reward network structural connectivity in this population-based cohort with a wide range of BMI and age. Future research should further investigate the link between genetics, obesity and fronto-striatal structural connectivity.
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Mole JP, Fasano F, Evans J, Sims R, Hamilton DA, Kidd E, Metzler-Baddeley C. Genetic risk of dementia modifies obesity effects on white matter myelin in cognitively healthy adults. Neurobiol Aging 2020; 94:298-310. [PMID: 32736120 DOI: 10.1016/j.neurobiolaging.2020.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 01/05/2023]
Abstract
APOE-ε4 is a major genetic risk factor for late-onset Alzheimer's disease that interacts with other risk factors, but the nature of such combined effects remains poorly understood. We quantified the impact of APOE-ε4, family history (FH) of dementia, and obesity on white matter (WM) microstructure in 165 asymptomatic adults (38-71 years old) using quantitative magnetization transfer and neurite orientation dispersion and density imaging. Microstructural properties of the fornix, parahippocampal cingulum, and uncinate fasciculus were compared with those in motor and whole-brain WM regions. Widespread interaction effects between APOE, FH, and waist-hip ratio were found in the myelin-sensitive macromolecular proton fraction from quantitative magnetization transfer. Among individuals with the highest genetic risk (FH+ and APOE-ε4), obesity was associated with reduced macromolecular proton fraction in the right parahippocampal cingulum, whereas no effects were present for those without FH. Risk effects on apparent myelin were moderated by hypertension and inflammation-related markers. These findings suggest that genetic risk modifies the impact of obesity on WM myelin consistent with neuroglia models of aging and late-onset Alzheimer's disease.
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Affiliation(s)
- Jilu P Mole
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | | | - John Evans
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Rebecca Sims
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Derek A Hamilton
- Department of Psychology, The University of New Mexico, Albuquerque, NM, USA
| | - Emma Kidd
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Claudia Metzler-Baddeley
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK.
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Does obesity exacerbate brain lesion volume and atrophy in patients with multiple sclerosis? Mult Scler Relat Disord 2020; 46:102502. [PMID: 32932165 DOI: 10.1016/j.msard.2020.102502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/26/2020] [Accepted: 09/09/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Obesity is common among patients with multiple sclerosis (pwMS) and has been shown to exacerbate central inflammation, a key factor in disease progression. The purpose of this cross-sectional study is to examine the possible relationships between obesity, as measured by body mass index (BMI), and MS-related brain changes in atrophy and lesion volume, as measured from MRI, in a large, representative sample of pwMS. METHODS BMI and MRI data, along with demographic and disease variables, were acquired from the Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) registry. Unadjusted and adjusted partial correlations, controlling for gender, race, age, education level, MS phenotype, disability and disease duration, examined the associations between BMI and MRI outcomes, which included brain parenchymal fraction, white matter fraction, gray matter fraction, thalamic volume, and T2 lesion volume. RESULTS The sample consisted of 3,046 pwMS. Unadjusted and adjusted BMI-MRI correlations accounted for between 0.4% and 2.0% of shared variance (R2). When considering the relationship between MRI outcomes and BMI category (normal weight, overweight, obese), multiple regression analyses continued to show minimal association, with BMI category accounting for no more than 1.5% of shared variance. CONCLUSIONS No clinically meaningful associations were found between BMI and MRI outcomes in this large, representative sample of MS patients, regardless of demographics and disease variables. These unexpected negative results will require replication with a longitudinal design using more precise measures of obesity.
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Cardiometabolic determinants of early and advanced brain alterations: Insights from conventional and novel MRI techniques. Neurosci Biobehav Rev 2020; 115:308-320. [DOI: 10.1016/j.neubiorev.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
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Neuroanatomical changes in white and grey matter after sleeve gastrectomy. Neuroimage 2020; 213:116696. [DOI: 10.1016/j.neuroimage.2020.116696] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/27/2020] [Indexed: 12/12/2022] Open
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Hayek D, Thams F, Flöel A, Antonenko D. Dentate Gyrus Volume Mediates the Effect of Fornix Microstructure on Memory Formation in Older Adults. Front Aging Neurosci 2020; 12:79. [PMID: 32265687 PMCID: PMC7098987 DOI: 10.3389/fnagi.2020.00079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 03/04/2020] [Indexed: 12/25/2022] Open
Abstract
Age-related deterioration in white and gray matter is linked to cognitive deficits. Reduced microstructure of the fornix, the major efferent pathway of the hippocampus, and volume of the dentate gyrus (DG), may cause age-associated memory decline. However, the linkage between these anatomical determinants and memory retrieval in healthy aging are poorly understood. In 30 older adults, we acquired diffusion tensor and T1-weighted images for individual deterministic tractography and volume estimation. A memory task, administered outside of the scanner to assess retrieval of learned associations, required discrimination of previously acquired picture-word pairs. The results showed that fornix fractional anisotropy (FA) and left DG volumes were related to successful retrieval. These brain-behavior associations were observed for correct rejections, but not hits, indicating specificity of memory network functioning for detecting false associations. Mediation analyses showed that left DG volume mediated the effect of fornix FA on memory (48%), but not vice versa. These findings suggest that reduced microstructure induces volume loss and thus negatively affects retrieval of learned associations, complementing evidence of a pivotal role of the fornix in healthy aging. Our study offers a neurobehavioral model to explain variability in memory retrieval in older adults, an important prerequisite for the development of interventions to counteract cognitive decline.
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Affiliation(s)
- Dayana Hayek
- Department of Neurology, NeuroCure Clinical Research Center, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität Berlin, Berlin, Germany.,Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, NeuroCure Clinical Research Center, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität Berlin, Berlin, Germany.,Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
| | - Daria Antonenko
- Department of Neurology, NeuroCure Clinical Research Center, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität Berlin, Berlin, Germany.,Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
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Park BY, Byeon K, Lee MJ, Kim SH, Park H. The orbitofrontal cortex functionally links obesity and white matter hyperintensities. Sci Rep 2020; 10:2930. [PMID: 32076088 PMCID: PMC7031356 DOI: 10.1038/s41598-020-60054-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/06/2020] [Indexed: 12/13/2022] Open
Abstract
Many studies have linked dysfunction in cognitive control-related brain regions with obesity and the burden of white matter hyperintensities (WMHs). This study aimed to explore how functional connectivity differences in the brain are associated with WMH burden and degree of obesity using resting-state functional magnetic resonance imaging (fMRI) in 182 participants. Functional connectivity measures were compared among four different groups: (1) low WMH burden, non-obese; (2) low WMH burden, obese; (3) high WMH burden, non-obese; and (4) high WMH burden, obese. At a large-scale network-level, no networks showed significant interaction effects, but the frontoparietal network showed a main effect of degree of obesity. At a finer node level, the orbitofrontal cortex showed interaction effects between periventricular WMH burden and degree of obesity. Higher functional connectivity was observed when the periventricular WMH burden and degree of obesity were both high. These results indicate that the functional connectivity of the orbitofrontal cortex is affected by the mutual interaction between the periventricular WMHs and degree of obesity. Our results suggest that this region links obesity with WMHs in terms of functional connectivity.
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Affiliation(s)
- Bo-Yong Park
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, H3A 2B4, Canada
| | - Kyoungseob Byeon
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, 16419, South Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, 16419, South Korea
| | - Mi Ji Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Se-Hong Kim
- Department of Family Medicine, St. Vincent's Hospital, Catholic University College of Medicine, Suwon, 16247, South Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, 16419, South Korea.
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, 16419, South Korea.
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Lampe L, Zhang R, Beyer F, Huhn S, Kharabian Masouleh S, Preusser S, Bazin PL, Schroeter ML, Villringer A, Witte AV. Visceral obesity relates to deep white matter hyperintensities via inflammation. Ann Neurol 2019; 85:194-203. [PMID: 30556596 PMCID: PMC6590485 DOI: 10.1002/ana.25396] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/15/2022]
Abstract
Objective White matter hyperintensities (WMHs) are linked to vascular risk factors and increase the risk of cognitive decline, dementia, and stroke. We here aimed to determine whether obesity contributes to regional WMHs using a whole‐brain approach in a well‐characterized population‐based cohort. Methods Waist‐to‐hip ratio (WHR), body mass index (BMI), systolic/diastolic blood pressure, hypertension, diabetes and smoking status, blood glucose and inflammatory markers, as well as distribution of WMH were assessed in 1,825 participants of the LIFE‐adult study (age, 20–82 years; BMI, 18.4–55.4 kg/m2) using high‐resolution 3‐Tesla magnetic resonance imaging. Voxel‐wise analyses tested if obesity predicts regional probability of WMH. Additionally, mediation effects of high‐sensitive C‐reactive protein and interleukin‐6 (IL6) measured in blood were related to obesity and WMH using linear regression and structural equation models. Results WHR related to higher WMH probability predominantly in the deep white matter, even after adjusting for effects of age, sex, and systolic blood pressure (mean ß = 0.0043 [0.0008 SE], 95% confidence interval, [0.00427, 0.0043]; threshold‐free cluster enhancement, family‐wise error‐corrected p < 0.05). Conversely, higher systolic blood pressure was associated with WMH in periventricular white matter regions. Mediation analyses indicated that both higher WHR and higher BMI contributed to increased deep‐to‐periventricular WMH ratio through elevated IL6. Interpretation Our results indicate an increased WMH burden selectively in the deep white matter in obese subjects with high visceral fat accumulation, independent of common obesity comorbidities such as hypertension. Mediation analyses proposed that visceral obesity contributes to deep white matter lesions through increases in proinflammatory cytokines, suggesting a pathomechanistic link. Longitudinal studies need to confirm this hypothesis. ANN NEUROL 2019;85:194–203.
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Affiliation(s)
- Leonie Lampe
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Rui Zhang
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Frauke Beyer
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sebastian Huhn
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Shahrzad Kharabian Masouleh
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Research Center Jülich, Institute of Neuroscience and Medicine (INM-7), Jülich, Germany
| | - Sven Preusser
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Pierre-Louis Bazin
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Spinoza Centre for Neuroimaging, Amsterdam, The Netherlands
| | - Matthias L Schroeter
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - A Veronica Witte
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Beyer F, Kharabian Masouleh S, Kratzsch J, Schroeter ML, Röhr S, Riedel-Heller SG, Villringer A, Witte AV. A Metabolic Obesity Profile Is Associated With Decreased Gray Matter Volume in Cognitively Healthy Older Adults. Front Aging Neurosci 2019; 11:202. [PMID: 31427957 PMCID: PMC6688742 DOI: 10.3389/fnagi.2019.00202] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/17/2019] [Indexed: 12/22/2022] Open
Abstract
Obesity is a risk factor for cognitive decline and gray matter volume loss in aging. Studies have shown that different metabolic factors, e.g., dysregulated glucose metabolism and systemic inflammation, might mediate this association. Yet, even though these risk factors tend to co-occur, they have mostly been investigated separately, making it difficult to establish their joint contribution to gray matter volume structure in aging. Here, we therefore aimed to determine a metabolic profile of obesity that takes into account different anthropometric and metabolic measures to explain differences in gray matter volume in aging. We included 748 elderly, cognitively healthy participants (age range: 60 - 79 years, BMI range: 17 - 42 kg/m2) of the LIFE-Adult Study. All participants had complete information on body mass index, waist-to-hip ratio, glycated hemoglobin, total blood cholesterol, high-density lipoprotein, interleukin-6, C-reactive protein, adiponectin and leptin. Voxelwise gray matter volume was extracted from T1-weighted images acquired on a 3T Siemens MRI scanner. We used partial least squares correlation to extract latent variables with maximal covariance between anthropometric, metabolic and gray matter volume and applied permutation/bootstrapping and cross-validation to test significance and reliability of the result. We further explored the association of the latent variables with cognitive performance. Permutation tests and cross-validation indicated that the first pair of latent variables was significant and reliable. The metabolic profile was driven by negative contributions from body mass index, waist-to-hip ratio, glycated hemoglobin, C-reactive protein and leptin and a positive contribution from adiponectin. It positively covaried with gray matter volume in temporal, frontal and occipital lobe as well as subcortical regions and cerebellum. This result shows that a metabolic profile characterized by high body fat, visceral adiposity and systemic inflammation is associated with reduced gray matter volume and potentially reduced executive function in older adults. We observed the highest contributions for body weight and fat mass, which indicates that factors underlying sustained energy imbalance, like sedentary lifestyle or intake of energy-dense food, might be important determinants of gray matter structure in aging.
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Affiliation(s)
- Frauke Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Subproject A1, CRC 1052 “Obesity Mechanisms”, University of Leipzig, Leipzig, Germany
| | - Shahrzad Kharabian Masouleh
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Matthias L. Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Subproject A1, CRC 1052 “Obesity Mechanisms”, University of Leipzig, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - A. Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Subproject A1, CRC 1052 “Obesity Mechanisms”, University of Leipzig, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
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Wassenaar TM, Yaffe K, van der Werf YD, Sexton CE. Associations between modifiable risk factors and white matter of the aging brain: insights from diffusion tensor imaging studies. Neurobiol Aging 2019; 80:56-70. [PMID: 31103633 PMCID: PMC6683729 DOI: 10.1016/j.neurobiolaging.2019.04.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/26/2019] [Accepted: 04/05/2019] [Indexed: 01/13/2023]
Abstract
There is increasing interest in factors that may modulate white matter (WM) breakdown and, consequentially, age-related cognitive and behavioral deficits. Recent diffusion tensor imaging studies have examined the relationship of such factors with WM microstructure. This review summarizes the evidence regarding the relationship between WM microstructure and recognized modifiable factors, including hearing loss, hypertension, diabetes, obesity, smoking, depressive symptoms, physical (in) activity, and social isolation, as well as sleep disturbances, diet, cognitive training, and meditation. Current cross-sectional evidence suggests a clear link between loss of WM integrity (lower fractional anisotropy and higher mean diffusivity) and hypertension, obesity, diabetes, and smoking; a relationship that seems to hold for hearing loss, social isolation, depressive symptoms, and sleep disturbances. Physical activity, cognitive training, diet, and meditation, on the other hand, may protect WM with aging. Preliminary evidence from cross-sectional studies of treated risk factors suggests that modification of factors could slow down negative effects on WM microstructure. Careful intervention studies are needed for this literature to contribute to public health initiatives going forward.
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Affiliation(s)
- Thomas M Wassenaar
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroscience, FMRIB Centre, University of Oxford, John Radcliffe Hospital, UK
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, VU University Medical Center, MC, Amsterdam, the Netherlands
| | - Claire E Sexton
- Department of Neurology, Global Brain Health Institute, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA; Department of Psychiatry, Wellcome Centre for Integrative Neuroscience, Oxford Centre for Human Brain Activity, University of Oxford, John Radcliffe Hospital, UK.
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Short-term improvements in cognitive function following vertical sleeve gastrectomy and Roux-en Y gastric bypass: a direct comparison study. Surg Endosc 2019; 34:2248-2257. [PMID: 31367985 DOI: 10.1007/s00464-019-07015-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cognitive deficits are observed in individuals with obesity. While bariatric surgery can reverse these deficits, it remains unclear whether surgery type differentially influences cognitive outcome. We compared the extent to which vertical sleeve gastrectomy (VSG) and Roux-en Y gastric bypass (RYGB) ameliorated cognitive impairments associated with obesity. METHODS Female participants approved for VSG (N = 18) or RYGB (N = 18) were administered cognitive measures spanning the domains of attention [Hopkins Verbal Learning Test (HVLT) Trial 1 and Letter Number Sequencing], processing speed [Stroop Color Trial, Symbol Digit Modalities Test, and Trail Making Part A], memory [HVLT Retained and HVLT Discrimination Index], and executive functioning (Stroop Color Word Trials and Trail Making Part B-A) prior to surgery and at 2 weeks and 3 months following surgery. Scores for each cognitive domain were calculated and compared between surgical cohorts using repeated measures analyses of variance. RESULTS Significant weight loss was observed 2 weeks and 3 months following RYGB and VSG and was accompanied by improvements in processing speed and executive functioning. Patients who received RYGB also experienced improved attention as early as 2 weeks, which persisted at 3 months. This was not observed in individuals who underwent VSG. No changes in memory were observed from baseline measures in either group. CONCLUSIONS This is the first report of cognitive improvements following VSG and the first direct comparison of cognitive improvements following RYGB and VSG. Short-term improvements in specific domains of cognitive function are observed at the beginning of the active weight loss phase following bariatric surgery that persisted to 3 months. The anatomical distinction between the two surgeries and resulting differential metabolic profiles may be responsible for the improvements in attention observed following RYGB but not following VSG.
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Zsido RG, Heinrich M, Slavich GM, Beyer F, Kharabian Masouleh S, Kratzsch J, Raschpichler M, Mueller K, Scharrer U, Löffler M, Schroeter ML, Stumvoll M, Villringer A, Witte AV, Sacher J. Association of Estradiol and Visceral Fat With Structural Brain Networks and Memory Performance in Adults. JAMA Netw Open 2019; 2:e196126. [PMID: 31225892 PMCID: PMC6593958 DOI: 10.1001/jamanetworkopen.2019.6126] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IMPORTANCE Changes in estradiol during aging are associated with increased dementia risk. It remains unclear how estradiol supports cognitive health and whether risk factors, such as midlife obesity, are exacerbated by estrogen loss. OBJECTIVES To assess whether visceral adipose tissue (VAT) moderates the association between age and brain network structure and to investigate whether estradiol moderates the association between VAT and brain network structure. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of data from 974 cognitively healthy adults in Germany who participated in the Health Study of the Leipzig Research Centre for Civilization Diseases, a previously described population-based cohort study. Two moderation analyses were performed, including VAT as the moderator variable between age and brain network structure and estradiol as the moderator variable between VAT and brain network structure. The study was conducted from August 1, 2011, to November 23, 2014. Analyses were conducted from August 2017 to September 2018. EXPOSURES Serum estradiol levels from fasting blood and visceral adipose tissue volume from T1-weighted magnetic resonance imaging (MRI). MAIN OUTCOMES AND MEASURES Brain network covariance (individual loading on structural network derived from T1-weighted MRI) and memory performance (composite score from the Consortium to Establish a Registry for Alzheimer Disease [CERAD] verbal episodic memory test on learning [score range, 0-30], recall [score range, 0-10], and recognition [score range, 0-20]). RESULTS Final analyses included data from 473 women (mean [SD] age, 50.10 [15.63] years) and 501 men (mean [SD] age, 51.24 [15.67] years). Visceral adipose tissue was associated with an exacerbation of the negative association of aging with network covariance for women (interaction term β = -0.02; 95% bias-corrected bootstrap CI, -0.03 to -0.01; P = .001) and men (interaction term β = -0.02; 95% bias-corrected bootstrap CI, -0.03 to -0.01; P < .001). Estradiol level was associated with a reduction in the negative association of VAT with network covariance in women (interaction term β = 0.63; 95% bias-corrected bootstrap CI, 0.14-1.12; P = .01), with no significant association in men. In the female midlife subgroup (age range, 35-55 years, when menopause transition occurs), low estradiol levels were associated with lower memory network covariance (Cohen d = 0.61; t80 = 2.76; P = .007) and worse memory performance (Cohen d = 0.63; t76 = 2.76; P = .007). CONCLUSIONS AND RELEVANCE This study reports a novel association between VAT, estradiol, and structural brain networks as a potential mechanism underlying cognitive decline in women. These findings appear to highlight the need for sex-specific strategies, including VAT and hormonal screening during midlife, to support healthy cognitive aging.
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Affiliation(s)
- Rachel G Zsido
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Matthias Heinrich
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Frauke Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Subproject A1, Collaborative Research Centre 1052 "Obesity Mechanisms," University of Leipzig, Leipzig, Germany
| | | | - Juergen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Matthias Raschpichler
- Heart Center Leipzig, Department of Cardiac Surgery, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Karsten Mueller
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ulrike Scharrer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Subproject A1, Collaborative Research Centre 1052 "Obesity Mechanisms," University of Leipzig, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - A Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Subproject A1, Collaborative Research Centre 1052 "Obesity Mechanisms," University of Leipzig, Leipzig, Germany
| | - Julia Sacher
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
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Fond G, Godin O, Schürhoff F, Berna F, Aouizerate B, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Faget C, Leignier S, Lançon C, Mallet J, Marulaz L, Misdrahi D, Passerieux C, Rey R, Schandrin A, Urbach M, Vidailhet P, Leboyer M, Boyer L, Llorca PM. Inflammatory DEpression Advances in Schizophrenia (IDEAS): A precision medicine approach of the national FACE-SZ cohort. J Affect Disord 2019; 245:468-474. [PMID: 30428447 DOI: 10.1016/j.jad.2018.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 09/16/2018] [Accepted: 11/01/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a therapeutic challenge in schizophrenia (SZ). Untangling different forms of MDD appears as the best current strategy to improve remission to treatment in the so-called precision medicine approach. AIMS The objectives of the present study were to determine (i) the prevalence of Inflammatory Depression (ID) in stabilized SZ outpatients (ii) if ID was associated with clinical or cognitive profiles that may help clinicians detecting ID (iii) if antidepressants were effective in ID and (iv) the biological correlates of ID that may orientate personalized treatments. METHOD Participants were consecutively included and received a thorough 2 days- clinical assessment. RESULTS 785 subjects were recruited in the FACE-SZ cohort. 289 (36.8%) were diagnosed with MDD (remitted or unremitted), of them 57 with ID (19.7%). No clinical or cognitive features were associated with ID (all p > 0.05). ID has been associated with increased abdominal perimeter (aOR = 4.48, p = 0.002) and latent Toxoplasma infection (aOR = 2.19, p = 0.04). While antidepressants were associated with decreased depressive symptoms level in ID, 44% of the subjects remained unremitted under antidepressant, with no association with CRP blood levels. CONCLUSIONS ID may not differ from other forms of depression by its clinical symptoms but by its aetiologies. ID is associated with increased perivisceral fat and latent Toxoplasma infection that are both potentially related to gut/microbiota disturbances. Specific anti-inflammatory drugs and microbiota-targeted therapeutics appear as promising strategies in the treatment of inflammatory depression in schizophrenia.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France.
| | - O Godin
- Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux F-33076, France; INRA, NutriNeuro, University of Bordeaux, U1286 F-33076, Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - S Leignier
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Lançon
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - L Marulaz
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux F-33076, France; CNRS UMR 5287-INCIA France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - R Rey
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - P Vidailhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | | | - L Boyer
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
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