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Tzounakou AM, Stathori G, Paltoglou G, Valsamakis G, Mastorakos G, Vlahos NF, Charmandari E. Childhood Obesity, Hypothalamic Inflammation, and the Onset of Puberty: A Narrative Review. Nutrients 2024; 16:1720. [PMID: 38892653 PMCID: PMC11175006 DOI: 10.3390/nu16111720] [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: 02/15/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
The onset of puberty, which is under the control of the hypothalamic-pituitary-gonadal (HPG) axis, is influenced by various factors, including obesity, which has been associated with the earlier onset of puberty. Obesity-induced hypothalamic inflammation may cause premature activation of gonadotropin-releasing hormone (GnRH) neurons, resulting in the development of precocious or early puberty. Mechanisms involving phoenixin action and hypothalamic microglial cells are implicated. Furthermore, obesity induces structural and cellular brain alterations, disrupting metabolic regulation. Imaging studies reveal neuroinflammatory changes in obese individuals, impacting pubertal timing. Magnetic resonance spectroscopy enables the assessment of the brain's neurochemical composition by measuring key metabolites, highlighting potential pathways involved in neurological changes associated with obesity. In this article, we present evidence indicating a potential association among obesity, hypothalamic inflammation, and precocious puberty.
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Affiliation(s)
- Anastasia-Maria Tzounakou
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.-M.T.); (G.S.)
| | - Galateia Stathori
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.-M.T.); (G.S.)
| | - George Paltoglou
- Diabetes Unit, Second Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘P. & A. Kyriakou’ Children’s Hospital, 11527 Athens, Greece;
| | - Georgios Valsamakis
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.V.); (G.M.); (N.F.V.)
| | - George Mastorakos
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.V.); (G.M.); (N.F.V.)
| | - Nikolaos F. Vlahos
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.V.); (G.M.); (N.F.V.)
| | - Evangelia Charmandari
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.-M.T.); (G.S.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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2
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Rebelos E, Latva-Rasku A, Koskensalo K, Pekkarinen L, Saukko E, Ihalainen J, Honka MJ, Tuisku J, Bucci M, Laurila S, Rajander J, Salminen P, Nummenmaa L, Jansen JFA, Ferrannini E, Nuutila P. Insulin-stimulated brain glucose uptake correlates with brain metabolites in severe obesity: A combined neuroimaging study. J Cereb Blood Flow Metab 2024; 44:407-418. [PMID: 37824728 PMCID: PMC10870965 DOI: 10.1177/0271678x231207114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 08/30/2023] [Accepted: 09/15/2023] [Indexed: 10/14/2023]
Abstract
The human brain undergoes metabolic adaptations in obesity, but the underlying mechanisms have remained largely unknown. We compared concentrations of often reported brain metabolites measured with magnetic resonance spectroscopy (1H-MRS, 3 T MRI) in the occipital lobe in subjects with obesity and lean controls under different metabolic conditions (fasting, insulin clamp, following weight loss). Brain glucose uptake (BGU) quantified with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)) was also performed in a subset of subjects during clamp. In dataset A, 48 participants were studied during fasting with brain 1H-MRS, while in dataset B 21 participants underwent paired brain 1H-MRS acquisitions under fasting and clamp conditions. In dataset C 16 subjects underwent brain 18F-FDG-PET and 1H-MRS during clamp. In the fasting state, total N-acetylaspartate was lower in subjects with obesity, while brain myo-inositol increased in response to hyperinsulinemia similarly in both lean participants and subjects with obesity. During clamp, BGU correlated positively with brain glutamine/glutamate, total choline, and total creatine levels. Following weight loss, brain creatine levels were increased, whereas increases in other metabolites remained not significant. To conclude, insulin signaling and glucose metabolism are significantly coupled with several of the changes in brain metabolites that occur in obesity.
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Affiliation(s)
- Eleni Rebelos
- Turku PET Centre, University of Turku, Turku, Finland
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Aino Latva-Rasku
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Kalle Koskensalo
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Laura Pekkarinen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Jukka Ihalainen
- Turku PET Centre, Accelerator Laboratory, Åbo Akademi University, Turku, Finland
| | | | - Jouni Tuisku
- Turku PET Centre, University of Turku, Turku, Finland
| | - Marco Bucci
- Turku PET Centre, University of Turku, Turku, Finland
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sanna Laurila
- Turku PET Centre, University of Turku, Turku, Finland
| | - Johan Rajander
- Turku PET Centre, Accelerator Laboratory, Åbo Akademi University, Turku, Finland
| | - Paulina Salminen
- Department of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
- Department of Surgery, University of Turku, Turku, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Psychology University of Turku, Turku, Finland
| | - Jacobus FA Jansen
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ele Ferrannini
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
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3
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Wu Y, De Asis-Cruz J, Limperopoulos C. Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy. Mol Psychiatry 2024:10.1038/s41380-024-02449-0. [PMID: 38418579 DOI: 10.1038/s41380-024-02449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 03/01/2024]
Abstract
In-utero exposure to maternal psychological distress is increasingly linked with disrupted fetal and neonatal brain development and long-term neurobehavioral dysfunction in children and adults. Elevated maternal psychological distress is associated with changes in fetal brain structure and function, including reduced hippocampal and cerebellar volumes, increased cerebral cortical gyrification and sulcal depth, decreased brain metabolites (e.g., choline and creatine levels), and disrupted functional connectivity. After birth, reduced cerebral and cerebellar gray matter volumes, increased cerebral cortical gyrification, altered amygdala and hippocampal volumes, and disturbed brain microstructure and functional connectivity have been reported in the offspring months or even years after exposure to maternal distress during pregnancy. Additionally, adverse child neurodevelopment outcomes such as cognitive, language, learning, memory, social-emotional problems, and neuropsychiatric dysfunction are being increasingly reported after prenatal exposure to maternal distress. The mechanisms by which prenatal maternal psychological distress influences early brain development include but are not limited to impaired placental function, disrupted fetal epigenetic regulation, altered microbiome and inflammation, dysregulated hypothalamic pituitary adrenal axis, altered distribution of the fetal cardiac output to the brain, and disrupted maternal sleep and appetite. This review will appraise the available literature on the brain structural and functional outcomes and neurodevelopmental outcomes in the offspring of pregnant women experiencing elevated psychological distress. In addition, it will also provide an overview of the mechanistic underpinnings of brain development changes in stress response and discuss current treatments for elevated maternal psychological distress, including pharmacotherapy (e.g., selective serotonin reuptake inhibitors) and non-pharmacotherapy (e.g., cognitive-behavior therapy). Finally, it will end with a consideration of future directions in the field.
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Affiliation(s)
- Yao Wu
- Developing Brain Institute, Children's National Hospital, Washington, DC, 20010, USA
| | | | - Catherine Limperopoulos
- Developing Brain Institute, Children's National Hospital, Washington, DC, 20010, USA.
- Department of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, 20010, USA.
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Bottari SA, Cohen RA, Friedman J, Porges EC, Chen A, Britton MK, Gunstad J, Woods AJ, Williamson JB. Change in medial frontal cerebral metabolite concentrations following bariatric surgery. NMR IN BIOMEDICINE 2023; 36:e4897. [PMID: 36628927 PMCID: PMC11017471 DOI: 10.1002/nbm.4897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/13/2022] [Accepted: 12/29/2022] [Indexed: 06/15/2023]
Abstract
Obesity is associated with adverse effects on brain health, including an increased risk of neurodegenerative diseases. Changes in cerebral metabolism may underlie or precede structural and functional brain changes. While bariatric surgery is known to be effective in inducing weight loss and improving obesity-related medical comorbidities, few studies have examined whether it may be able to improve brain metabolism. In the present study, we examined changes in cerebral metabolite concentrations in participants with obesity who underwent bariatric surgery. Thirty-five patients with obesity (body mass index ≥ 35 kg/m2 ) were recruited from a bariatric surgery candidate nutrition class. They completed single voxel proton magnetic resonance spectroscopy at baseline (presurgery) and within 1 year postsurgery. Spectra were obtained from a large medial frontal brain region using a PRESS sequence on a 3-T Siemens Verio scanner. The acquisition parameters were TR = 3000 ms and TE = 37 ms. Tissue-corrected metabolite concentrations were determined using Osprey. Paired t-tests were used to examine within-subject change in metabolite concentrations, and correlations were used to relate these changes to other health-related outcomes, including weight loss and glycated hemoglobin (HbA1c ), a measure of blood sugar levels. Bariatric surgery was associated with a reduction in cerebral choline-containing compounds (Cho; t [34] = - 3.79, p < 0.001, d = -0.64) and myo-inositol (mI; t [34] = - 2.81, p < 0.01, d = -0.47) concentrations. There were no significant changes in N-acetyl-aspartate, creatine, or glutamate and glutamine concentrations. Reductions in Cho were associated with greater weight loss (r = 0.40, p < 0.05), and reductions in mI were associated with greater reductions in HbA1c (r = 0.44, p < 0.05). In conclusion, participants who underwent bariatric surgery exhibited reductions in cerebral Cho and mI concentrations, which were associated with improvements in weight loss and glycemic control. Given that elevated levels of Cho and mI have been implicated in neuroinflammation, reduction in these metabolites after bariatric surgery may reflect amelioration of obesity-related neuroinflammatory processes. As such, our results provide evidence that bariatric surgery may improve brain health and metabolism in individuals with obesity.
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Affiliation(s)
- Sarah A. Bottari
- Center for OCD, Anxiety, and Related Disorders, Department of Psychiatry, University of Florida, Gainesville, Florida, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Ronald A. Cohen
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, Florida, USA
| | - Jeffrey Friedman
- UF Health Bariatric Surgery Center, Department of Surgery, University of Florida, Gainesville, Florida, USA
| | - Eric C. Porges
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, Florida, USA
| | - Alexa Chen
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Mark K. Britton
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Adam J. Woods
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - John B. Williamson
- Center for OCD, Anxiety, and Related Disorders, Department of Psychiatry, University of Florida, Gainesville, Florida, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, Florida, USA
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Vints WA, Kušleikienė S, Sheoran S, Valatkevičienė K, Gleiznienė R, Himmelreich U, Pääsuke M, Česnaitienė VJ, Levin O, Verbunt J, Masiulis N. Body fat and components of sarcopenia relate to inflammation, brain volume and neurometabolism in older adults. Neurobiol Aging 2023; 127:1-11. [PMID: 37004309 DOI: 10.1016/j.neurobiolaging.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/27/2022] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
Obesity and sarcopenia are associated with cognitive impairments at older age. Current research suggests that blood biomarkers may mediate this body-brain crosstalk, altering neurometabolism and brain structure eventually resulting in cognitive performance changes. Seventy-four older adults (60-85 years old) underwent bio-impedance body composition analysis, handgrip strength measurements, 8-Foot Up-and-Go (8UG) test, Montreal Cognitive Assessment (MoCA), blood analysis of interleukin-6 (IL-6), kynurenine, and insulin-like growth factor-1 (IGF-1), as well as brain magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS), estimating neurodegeneration and neuroinflammation. Normal fat% or overweight was associated with larger total gray matter volume compared to underweight or obesity in older adults and obesity was associated with higher N-acetylaspartate/Creatine levels in the sensorimotor and dorsolateral prefrontal cortex. Muscle strength, not muscle mass/physical performance, corresponded to lower kynurenine and higher N-acetylaspartate/Creatine levels in the dorsal posterior cingulate and dorsolateral prefrontal cortex. The inflammatory and neurotrophic blood biomarkers did not significantly mediate these body-brain associations. This study used a multimodal approach to comprehensively assess the proposed mechanism of body-brain crosstalk.
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Valkenborghs SR, Hillman CH, Al‐Iedani O, Nilsson M, Smith JJ, Leahy AA, Harries SK, Ramadan S, Lubans DR. Effect of high-intensity interval training on hippocampal metabolism in older adolescents. Psychophysiology 2022; 59:e14090. [PMID: 35599295 PMCID: PMC9787522 DOI: 10.1111/psyp.14090] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/30/2022]
Abstract
Although well-evidenced in older adults, the effects of exercise on the hippocampus in youth are relatively unknown. This study examined the impact of a 6-month school-based physical activity intervention on hippocampal metabolism in adolescents using magnetic resonance spectroscopy. A subset of lower fit older adolescents [N = 56, 61% female, 16.1 ± 0.4 years] was included from four secondary schools (10 classes) in New South Wales, Australia, who were participating in a larger cluster randomized controlled trial. Participants were randomized to the Burn 2 Learn (B2L) intervention (five classes, 30 participants) or a control group (five classes, 26 participants). Changes in hippocampal metabolism were assessed using linear mixed models adjusted for clustering at the class level. We observed group-by-time effects for the B2L intervention on N-acetylaspartate (NAA) (+2.66 mmol/L, 95% CI 0.20 to 5.11, d = 0.66) and glutamate+glutamine (Glx) (+3.38 mmol/L, 95% CI 0.34 to 6.42, d = 0.67) in the left hippocampus. Increases in left hippocampal NAA and Glx concentrations were associated with improvements in cardiorespiratory fitness (NAA: rs = 0.52, p = .016; Glx: rs = 0.57, p = .007), lower body muscular fitness (NAA: rs = 0.49, p = .018; Glx: rs = 0.59, p = .003), and working memory (NAA: rs = 0.42, p = .032; Glx: rs = 0.43, p = .028) in the intervention group. Our findings suggest physical activity may improve hippocampal metabolism in lower fit older adolescents with implications for working memory. Further studies involving larger samples are needed to replicate our findings.
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Affiliation(s)
- Sarah Ruth Valkenborghs
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia,Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia
| | - Charles H. Hillman
- Center for Cognitive & Brain Health, Department of Psychology, Department of Physical Therapy, Movement, and Rehabilitation SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Oun Al‐Iedani
- School of Health SciencesThe University of NewcastleCallaghanNew South WalesAustralia
| | - Michael Nilsson
- Centre for Rehab InnovationsThe University of NewcastleCallaghanNew South WalesAustralia,Priority Research Centre for Stroke and Brain InjuryThe University of NewcastleCallaghanNew South WalesAustralia,School of Medicine and Public HealthThe University of NewcastleCallaghanNew South WalesAustralia
| | - Jordan J. Smith
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Angus Aaron Leahy
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Simon K. Harries
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Saadallah Ramadan
- School of Health SciencesThe University of NewcastleCallaghanNew South WalesAustralia
| | - David Revalds Lubans
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
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Neves TMG, Simoes E, Otaduy MCG, Calfat ELDB, Bertolazzi P, da Costa NA, Duran FLDS, Correia-Lima J, Martin MDGM, Seelander MCL, Otani VHO, Otani TZDS, Vasques DAC, Filho GB, Kochi C, Uchida RR. Inverse Association Between Hypothalamic N-Acetyl Aspartate/Creatine Ratio and Indices of Body Mass in Adolescents with Obesity. J Nutr 2021; 152:663-670. [PMID: 34888674 PMCID: PMC8891176 DOI: 10.1093/jn/nxab415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/06/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Approximately 10% of adolescents worldwide are overweight or obese, hence the urgent and universal need to elucidate possible mechanisms that lead to obesity in the adolescent population. OBJECTIVES We examined the hypothalamic metabolism and its relationship with physical development in obese and eutrophic adolescents. METHODS We performed a case-control study with 115 adolescents between 11 and 18 years of age, to compare obese (BMI z-score ≥ 2) and nonobese individuals (eutrophic controls; BMI z-score ≤ 1). The following hypothalamic metabolite ratios were examined as primary outcomes: glutamate/creatine (Cr), the sum of glutamate and glutamine/Cr, N-acetylaspartate (NAA)/Cr, myoinositol/Cr, and total choline/Cr (glycerophosphocholine + phosphocholine/Cr), quantified by magnetic resonance spectroscopy. BMI z-scores, pubertal status, and scores on the Yale Food Addiction Scale, the Binge Eating Scale, and the Child Depression Inventory were assessed as secondary outcomes. Pearson coefficients (r) or nonparametric Spearman correlation (rho) analyses were performed between hypothalamic metabolite ratios and other parameters, such as BMI z-scores, physical development, food habits, depression symptoms, and serum protein concentrations (cytokines, hormones, and neuropeptides). RESULTS Adolescents with obesity showed a lower hypothalamic NAA/Cr ratio (0.70 ± 0.19) compared to their eutrophic counterparts (0.84 ± 0.20; P = 0.004). The NAA/Cr ratio was negatively correlated with BMI z-scores (r = -0.25; P = 0.03) and serum insulin (rho = -0.27; P = 0.04), C-peptide (rho = -0.26; P = 0.04), amylin (r = -0.27; P = 0.04), ghrelin (rho = -0.30; P = 0.02), and neuropeptide Y (r = -0.27; P = 0.04). Also, the NAA/Cr ratio was positively correlated with circulating IL-8 levels (rho = 0.26; P = 0.04). CONCLUSIONS High BMI z-scores are associated with lower hypothalamic NAA/Cr ratios. The negative correlations found between the NAA/Cr ratio and serum cytokines, hormones, and neuropeptides suggest a broad cross-talk linking hormonal imbalances, neurohumoral alterations, and hypothalamic functions in adolescents with obesity.
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Affiliation(s)
| | | | | | | | - Pâmela Bertolazzi
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Naomi Antunes da Costa
- Neuroimaging Laboratory (LIM-21), Institute Psychiatry, University of São Paulo, São Paulo, Brazil
| | | | - Joanna Correia-Lima
- Cancer Metabolism Research Group, University of São Paulo, São Paulo, Brazil
| | | | - Marília Cerqueira Leite Seelander
- Cancer Metabolism Research Group, University of São Paulo, São Paulo, Brazil,Department of Surgery and LIM 26, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Geraldo Busatto Filho
- Neuroimaging Laboratory (LIM-21), Institute Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Cristiane Kochi
- Pediatrics Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Ricardo Riyoiti Uchida
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
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8
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Gajdošík M, Landheer K, Swanberg KM, Adlparvar F, Madelin G, Bogner W, Juchem C, Kirov II. Hippocampal single-voxel MR spectroscopy with a long echo time at 3 T using semi-LASER sequence. NMR IN BIOMEDICINE 2021; 34:e4538. [PMID: 33956374 PMCID: PMC10874619 DOI: 10.1002/nbm.4538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/01/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
The hippocampus is one of the most challenging brain regions for proton MR spectroscopy (MRS) applications. Moreover, quantification of J-coupled species such as myo-inositol (m-Ins) and glutamate + glutamine (Glx) is affected by the presence of macromolecular background. While long echo time (TE) MRS eliminates the macromolecules, it also decreases the m-Ins and Glx signal and, as a result, these metabolites are studied mainly with short TE. Here, we investigate the feasibility of reproducibly measuring their concentrations at a long TE of 120 ms, using a semi-adiabatic localization by adiabatic selective refocusing (sLASER) sequence, as this sequence was recently recommended as a standard for clinical MRS. Gradient offset-independent adiabatic refocusing pulses were implemented, and an optimal long TE for the detection of m-Ins and Glx was determined using the T2 relaxation times of macromolecules. Metabolite concentrations and their coefficients of variation (CVs) were obtained for a 3.4-mL voxel centered on the left hippocampus on 3-T MR systems at two different sites with three healthy subjects (aged 32.5 ± 10.2 years [mean ± standard deviation]) per site, with each subject scanned over two sessions, and with each session comprising three scans. Concentrations of m-Ins, choline, creatine, Glx and N-acetyl-aspartate were 5.4 ± 1.5, 1.7 ± 0.2, 5.8 ± 0.3, 11.6 ± 1.2 and 5.9 ± 0.4 mM (mean ± standard deviation), respectively. Their respective mean within-session CVs were 14.5% ± 5.9%, 6.5% ± 5.3%, 6.0% ± 3.4%, 10.6% ± 6.2% and 3.5% ± 1.4%, and their mean within-subject CVs were 17.8% ± 18.2%, 7.5% ± 6.3%, 7.4% ± 6.4%, 12.4% ± 5.3% and 4.8% ± 3.0%. The between-subject CVs were 25.0%, 12.3%, 5.3%, 10.7% and 6.4%, respectively. Hippocampal long-TE sLASER single voxel spectroscopy can provide macromolecule-independent assessment of all major metabolites including Glx and m-Ins.
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Affiliation(s)
- Martin Gajdošík
- Center for Advanced Imaging Innovation and Research (CAIR), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States
| | - Karl Landheer
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States
| | - Kelley M. Swanberg
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States
| | - Fatemeh Adlparvar
- Center for Advanced Imaging Innovation and Research (CAIR), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States
| | - Guillaume Madelin
- Center for Advanced Imaging Innovation and Research (CAIR), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States
| | - Wolfgang Bogner
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Christoph Juchem
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States
- Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Ivan I. Kirov
- Center for Advanced Imaging Innovation and Research (CAIR), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
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9
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Bond DJ, Silveira LE, Torres IJ, Lam RW, Yatham LN. Weight gain as a risk factor for progressive neurochemical abnormalities in first episode mania patients: a longitudinal magnetic resonance spectroscopy study. Psychol Med 2021; 52:1-9. [PMID: 33706825 DOI: 10.1017/s0033291721000544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND We previously reported that bipolar disorder (BD) patients with clinically significant weight gain (CSWG; ⩾7% of baseline weight) in the 12 months after their first manic episode experienced greater limbic brain volume loss than patients without CSWG. It is unknown whether CSWG is also a risk factor for progressive neurochemical abnormalities. METHODS We investigated whether 12-month CSWG predicted greater 12-month decreases in hippocampal N-acetylaspartate (NAA) and greater increases in glutamate + glutamine (Glx) following a first manic episode. In BD patients (n = 58) and healthy comparator subjects (HS; n = 34), we measured baseline and 12-month hippocampal NAA and Glx using bilateral 3-Tesla single-voxel proton magnetic resonance spectroscopy. We used general linear models for repeated measures to investigate whether CSWG predicted neurochemical changes. RESULTS Thirty-three percent of patients and 18% of HS experienced CSWG. After correcting for multiple comparisons, CSWG in patients predicted a greater decrease in left hippocampal NAA (effect size = -0.52, p = 0.005). CSWG also predicted a greater decrease in left hippocampal NAA in HS with a similar effect size (-0.53). A model including patients and HS found an effect of CSWG on Δleft NAA (p = 0.007), but no diagnosis effect and no diagnosis × CSWG interaction, confirming that CSWG had similar effects in patients and HS. CONCLUSION CSWG is a risk factor for decreasing hippocampal NAA in BD patients and HS. These results suggest that the well-known finding of reduced NAA in BD may result from higher body mass index in patients rather than BD diagnosis.
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Affiliation(s)
- David J Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - Leonardo E Silveira
- Laboratory of Molecular Psychiatry, Centro de Pesquisas Experimentais, Hospital de Clínicas de Porto Alegre, and INCT for Translational Medicine, Porto Alegre, RS, Brazil
| | - Ivan J Torres
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - Raymond W Lam
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
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10
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Pigoni A, Delvecchio G, Squarcina L, Bonivento C, Girardi P, Finos L, Crisanti C, Balestrieri M, D'Agostini S, Stanley JA, Brambilla P. Sex differences in brain metabolites in anxiety and mood disorders. Psychiatry Res Neuroimaging 2020; 305:111196. [PMID: 33010582 DOI: 10.1016/j.pscychresns.2020.111196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 01/16/2023]
Abstract
Gender differences in mood and anxiety disorders are well-established. However, the neural basis of these differences is not clear yet, especially in terms of brain metabolism. Indeed, although several proton Magnetic Resonance Spectroscopy (¹H MRS) investigations reported different metabolic levels in both depression and anxiety disorders, which have been also linked to symptoms severity and response to treatment, the role of gender on these differences have not been explored yet. Therefore, this study aims at investigating the role of sex in neurometabolic alterations associated with both mood and anxiety disorders. A 3T single-voxel ¹H MRS acquisition of the dorsolateral prefrontal cortex was acquired from 14 Major Depressive Disorder, 10 Generalized Anxiety Disorder (GAD), 11 Panic Disorder (PD), patients and 16 healthy controls (HC). Among males, PD patients showed significantly lower GPC+PC (also observed in GAD+PD) and Glu levels compared to HC. Finally, a significant group x sex interaction effect was observed in the GPC+PC and Glu levels. We proved the presence of an association between sex and brain metabolites in anxiety spectrum.
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Affiliation(s)
- Alessandro Pigoni
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Paolo Girardi
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Camilla Crisanti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Serena D'Agostini
- Department of Neuroradiology, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI,USA
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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11
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Larsen RJ, Raine LB, Hillman CH, Kramer AF, Cohen NJ, Barbey AK. Body mass and cardiorespiratory fitness are associated with altered brain metabolism. Metab Brain Dis 2020; 35:999-1007. [PMID: 32350752 DOI: 10.1007/s11011-020-00560-z] [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] [Received: 12/31/2019] [Accepted: 03/05/2020] [Indexed: 12/23/2022]
Abstract
Magnetic Resonance Spectroscopy provides measures of brain chemistry that are sensitive to cardiorespiratory fitness and body composition. The concentration of N-acetyl aspartic acid (NAA) is of interest because it is a marker of neuronal integrity. The ratio of NAA to creatine, a standard reference metabolite, has been shown to correlate with measures of both cardiorespiratory fitness and body composition. However, previous studies have explored these effects in isolation, making it impossible to know which of these highly correlated measures drive the correlations with NAA/Cr. As a result, the mechanisms underlying their association remain to be established. We therefore conducted a comprehensive study to investigate the relative contributions of cardiorespiratory fitness and percent body fat in predicting NAA/Cr. We demonstrate that NAA/Cr in white matter is correlated with percent body fat, and that this relationship largely subsumes the correlation of NAA/Cr with cardiorespiratory fitness. These results underscore the association of body composition with axonal integrity and suggests that this relationship drives the association of NAA/Cr with physical fitness in young adults.
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Affiliation(s)
- Ryan J Larsen
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana, Champaign, IL, USA.
| | - Lauren B Raine
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Charles H Hillman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana, Champaign, IL, USA
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana, Champaign, IL, USA
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Neal J Cohen
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana, Champaign, IL, USA
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Aron K Barbey
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana, Champaign, IL, USA
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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12
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Wu Y, Lu YC, Jacobs M, Pradhan S, Kapse K, Zhao L, Niforatos-Andescavage N, Vezina G, du Plessis AJ, Limperopoulos C. Association of Prenatal Maternal Psychological Distress With Fetal Brain Growth, Metabolism, and Cortical Maturation. JAMA Netw Open 2020; 3:e1919940. [PMID: 31995213 PMCID: PMC6991285 DOI: 10.1001/jamanetworkopen.2019.19940] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Prenatal maternal stress is increasingly associated with adverse outcomes in pregnant women and their offspring. However, the association between maternal stress and human fetal brain growth and metabolism is unknown. OBJECTIVE To identify the association between prenatal maternal psychological distress and fetal brain growth, cortical maturation, and biochemical development using advanced 3-dimensional volumetric magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS). DESIGN, SETTING, AND PARTICIPANTS This cohort study prospectively recruited pregnant women from low-risk obstetric clinics in Washington, DC, from January 1, 2016, to April 17, 2019. Participants were healthy volunteers with a normal prenatal medical history, no chronic or pregnancy-induced physical or mental illnesses, and normal results on fetal ultrasonography and biometry studies. Fetal brain MRI studies were performed at 2 time points between 24 and 40 weeks' gestation. EXPOSURES Prenatal maternal stress, anxiety, and depression. MAIN OUTCOMES AND MEASURES Volumes of fetal total brain, cortical gray matter, white matter, deep gray matter, cerebellum, brainstem, and hippocampus were measured from 3-dimensional reconstructed T2-weighted MRI scans. Cortical folding measurements included local gyrification index, sulcal depth, and curvedness. Fetal brain N-acetylaspartate, creatine, and choline levels were quantified using 1H-MRS. Maternal stress, depression, and anxiety were measured with the Perceived Stress Scale (PSS), Edinburgh Postnatal Depression Scale (EPDS), Spielberger State Anxiety Inventory (SSAI), and Spielberger Trait Anxiety Inventory (STAI). RESULTS A total of 193 MRI studies were performed in 119 pregnant women (67 [56%] carrying male fetuses and 52 [44%], female fetuses; maternal mean [SD] age, 34.46 [5.95] years) between 24 and 40 gestational weeks. All women were high school graduates, 99 (83%) were college graduates, and 100 (84%) reported professional employment. Thirty-two women (27%) had positive scores for stress, 31 (26%) for anxiety, and 13 (11%) for depression. Maternal trait anxiety was associated with smaller fetal left hippocampal volume (STAI score: -0.002 cm3; 95% CI, -0.003 to -0.0008 cm3; P = .004). Maternal anxiety and stress were associated with increased fetal cortical gyrification in the frontal lobe (β for SSAI score: 0.004 [95% CI, 0.001-0.006; P = .002]; β for STAI score: 0.004 [95% CI, 0.002-0.006; P < .001]; β for PSS score: 0.005 [95% CI, 0.001-0.008; P = .005]) and temporal lobe (β for SSAI score: 0.004 [95% CI, 0.001-0.007; P = .004]; β for STAI score: 0.004 [95% CI, 0.0008-0.006; P = .01]). Elevated maternal depression was associated with decreased creatine (EPDS score: -0.04; 95% CI, -0.06 to -0.02; P = .005) and choline (EPDS score: -0.03; 95% CI, -0.05 to -0.01; P = .02) levels in the fetal brain. CONCLUSIONS AND RELEVANCE This study found that the prevalence of maternal psychological distress in healthy, well-educated, and employed pregnant women was high, underappreciated, and associated with impaired fetal brain biochemistry and hippocampal growth as well as accelerated cortical folding. These findings appear to support the need for routine mental health surveillance for all pregnant women and targeted interventions in women with elevated psychological distress.
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Affiliation(s)
- Yao Wu
- Center for the Developing Brain, Children’s National Hospital, Washington, DC
| | - Yuan-Chiao Lu
- Center for the Developing Brain, Children’s National Hospital, Washington, DC
| | - Marni Jacobs
- Department of Biostatistics and Study Methodology, Children’s Research Institute, Children’s National Hospital, Washington, DC
| | - Subechhya Pradhan
- Center for the Developing Brain, Children’s National Hospital, Washington, DC
| | - Kushal Kapse
- Center for the Developing Brain, Children’s National Hospital, Washington, DC
| | - Li Zhao
- Center for the Developing Brain, Children’s National Hospital, Washington, DC
| | | | - Gilbert Vezina
- Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC
| | | | - Catherine Limperopoulos
- Center for the Developing Brain, Children’s National Hospital, Washington, DC
- Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC
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13
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Daniele G, Campi B, Saba A, Codini S, Ciccarone A, Giusti L, Del Prato S, Esterline RL, Ferrannini E. Plasma N-Acetylaspartate Is Related to Age, Obesity, and Glucose Metabolism: Effects of Antidiabetic Treatment and Bariatric Surgery. Front Endocrinol (Lausanne) 2020; 11:216. [PMID: 32362872 PMCID: PMC7181885 DOI: 10.3389/fendo.2020.00216] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/25/2020] [Indexed: 01/06/2023] Open
Abstract
Background: N-acetylaspartate (NAA) is synthesized only by neurons and is involved in neuronal metabolism and axonal myelination. NAA is the strongest signal on brain magnetic resonance spectroscopy, and its concentration have been associated with cognitive dysfunction in neurodegenerative diseases, obesity, and type 2 diabetes (T2D). Materials and Methods: We explored the impact of obesity and T2D on circulating NAA as well as the impact of bariatric surgery and antidiabetic treatments. We developed an LC-MS method for the accurate measurements of fasting plasma NAA levels in 505 subjects (156 subjects with normal glucose tolerance, 24 subjects with impaired glucose tolerance, and 325 patients with T2D) to examine the associations of NAA with obesity and dysglycemia. To validate cross-sectional findings, plasma NAA was measured 6 months after Roux-en-Y Gastric Bypass (RYGB) in 55 morbidly obese subjects, and after 1 year of antidiabetic treatment (with dapagliflozin, exenatide, or dapagliflozin plus exenatide) in 192 T2D patients. Results: In the whole population, NAA was associated with age (r = 0.31, p <0.0001) and BMI (r = -0.20, p <0.0001). Independently of age and BMI, NAA was reciprocally related to HbA1c and fasting plasma glucose (partial r = -0.13, both p = 0.01). Surgically-induced weight loss raised NAA (by 18 nmol/L on average, p <0.02). Glucose lowering treatment increased NAA in proportion to the drop in HbA1c (r = 0.31, p <0.0001) regardless of the agent used. Conclusions: Circulating NAA concentrations are modulated by age, obesity, and glycemic control. Whether they may mark for the corresponding metabolic effects on brain function remains to be established by joint measurements of spectroscopic signal and cognitive function.
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Affiliation(s)
- Giuseppe Daniele
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Saba
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Laboratory of Clinical Pathology, St. Chiara University Hospital, Pisa, Italy
| | - Simone Codini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annamaria Ciccarone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Giusti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Ele Ferrannini
- C.N.R. Institute of Clinical Physiology, Pisa, Italy
- *Correspondence: Ele Ferrannini
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14
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Rapid metabolic shifts occur during the transition between hunger and satiety in Drosophila melanogaster. Nat Commun 2019; 10:4052. [PMID: 31492856 PMCID: PMC6731244 DOI: 10.1038/s41467-019-11933-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 08/13/2019] [Indexed: 02/06/2023] Open
Abstract
Metabolites are active controllers of cellular physiology, but their role in complex behaviors is less clear. Here we report metabolic changes that occur during the transition between hunger and satiety in Drosophila melanogaster. To analyze these data in the context of fruit fly metabolic networks, we developed Flyscape, an open-access tool. We show that in response to eating, metabolic profiles change in quick, but distinct ways in the heads and bodies. Consumption of a high sugar diet dulls the metabolic and behavioral differences between the fasted and fed state, and reshapes the way nutrients are utilized upon eating. Specifically, we found that high dietary sugar increases TCA cycle activity, alters neurochemicals, and depletes 1-carbon metabolism and brain health metabolites N-acetyl-aspartate and kynurenine. Together, our work identifies the metabolic transitions that occur during hunger and satiation, and provides a platform to study the role of metabolites and diet in complex behavior. The relationship between metabolomic and behavioral changes is not well understood. Here, the authors analyze metabolome changes in D. melanogaster heads and bodies during hunger and satiety, and develop the Flyscape tool to visualize the resulting metabolic networks and integrate them with other omics data.
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15
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Weinland C, Mühle C, Kornhuber J, Lenz B. Body mass index and craving predict 24-month hospital readmissions of alcohol-dependent in-patients following withdrawal. Prog Neuropsychopharmacol Biol Psychiatry 2019; 90:300-307. [PMID: 30496769 DOI: 10.1016/j.pnpbp.2018.11.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/31/2018] [Accepted: 11/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Addictive alcohol drinking, craving, and overeating share common etiopathological mechanisms. We investigated whether body mass index (BMI) and craving predict outcome of alcohol-dependent in-patients. METHOD The prospective study included 101 male and 72 female early-abstinent alcohol-dependent in-patients. Craving was quantified by Obsessive-Compulsive Drinking Scale (OCDS) scores. We documented alcohol-related readmissions over 24 months. RESULTS In males, a higher BMI was associated with alcohol-related hospital readmission (median 26.1 vs. 23.1 kg/m2, P = .007) and correlated with more (ρ = 0.286, P = .004) and earlier readmissions (ρ = -0.256, P = .010). These associations were stronger in the subgroup of active smokers (n = 79; median 25.9 vs. 22.3 kg/m2, P = .005; ρ = 0.350, P = .002; ρ = -0.340, P = .002). BMI did not significantly predict outcome in females. Males with at least one readmission reported higher OCDS scores than those without (OCDS-total, OCDS-obsessive, OCDS-compulsive, P < .040), and the OCDS scores correlated with more readmissions (males: OCDS-total, OCDS-obsessive, OCDS-compulsive, ρ > 0.244, P < .014; females: OCDS-compulsive, ρ = 0.341, P = .003) and fewer days to first readmission (males: OCDS-total, OCDS-compulsive, ρ < -0.195, P < .050; females: OCDS-compulsive, ρ = -0.335, P = .004). The OCDS scores explained 9 to 19% of the relationship between BMI and outcome in males. CONCLUSION BMI and craving are easily accessible outcome predictors of alcohol-related readmission following in-patient withdrawal treatment. They might be used to individualize relapse prevention in the future.
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Affiliation(s)
- Christian Weinland
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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16
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Coplan JD, Lu D, El Sehamy AM, Tang C, Jackowski AP, Abdallah CG, Nemeroff CB, Owens MJ, Mathew SJ, Gorman JM. Early Life Stress Associated With Increased Striatal N-Acetyl-Aspartate: Cerebrospinal Fluid Corticotropin-Releasing Factor Concentrations, Hippocampal Volume, Body Mass and Behavioral Correlates. ACTA ACUST UNITED AC 2018; 2. [PMID: 29963652 PMCID: PMC6020138 DOI: 10.1177/2470547018768450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Using proton magnetic resonance spectroscopy imaging, the effects of early
life stress on nonhuman primate striatal neuronal integrity were examined as
reflected by N-acetyl aspartate (NAA) concentrations. NAA
measures were interrogated through examining their relationship to
previously documented early life stress markers—cerebrospinal fluid
corticotropin-releasing factor concentrations, hippocampal volume, body
mass, and behavioral timidity. Rodent models of depression exhibit increases
in neurotrophic effects in the nucleus accumbens. We hypothesized that
rearing under conditions of early life stress (variable foraging demand,
VFD) would produce persistent elevations of NAA concentrations (in absolute
or ratio form) in ventral striatum/caudate nucleus (VS/CN) with altered
correlation to early life stress markers. Methods Eleven bonnet macaque males reared under VFD conditions and seven age-matched
control subjects underwent proton magnetic resonance spectroscopy imaging
during young adulthood. Voxels were placed over VS/CN to capture nucleus
accumbens. Cisternal cerebrospinal fluid corticotropin-releasing factor
concentrations, hippocampal volume, body mass, and response to a human
intruder had been previously determined. Results VFD-reared monkeys exhibited significantly increased NAA/creatine
concentrations in right VS/CN in comparison to normally reared controls,
controlling for multiple comparisons. In comparison to controls, VFD
cerebrospinal fluid corticotropin-releasing factor concentrations were
directly associated with right VS/CN absolute NAA. Left hippocampal volume
was inversely associated with left VS/CN NAA/creatine in VFD reared but not
in controls. Disruption of a normative inverse correlation between left
VS/CN NAA and body mass was noted in VFD. Only non-VFD subjects exhibited a
direct relationship between timidity response to an intruder and right VS/CN
NAA. Conclusion Early life stress produced persistent increases in VS/CN NAA, which
demonstrated specific patterns of association (or lack thereof) to early
life stress markers in comparison to non-VFD subjects. The data are broadly
consistent with a stable nonhuman primate phenotype of anxiety and mood
disorder vulnerability whereby in vivo indicators of neuronal integrity,
although reduced in hippocampus, are increased in striatum. The findings may
provide a catalyst for further studies in humans and other species regarding
a reciprocal hippocampal/nucleus accumbens relationship in affective
disorders.
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Affiliation(s)
- Jeremy D Coplan
- Department of Psychiatry & Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY
| | - Dunyue Lu
- McLaren Behavioral Health Services, Flint Township, MI, USA
| | | | - Cheuk Tang
- Departments of Psychiatry, Neuroscience, and Radiology, Mount Sinai School of Medicine, New York, NY, USA
| | | | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami Health Systems, Miami, NY, USA
| | - Michael J Owens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. Debakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jack M Gorman
- Franklin Behavioral Health Care Consultants and Critica LLC, Bronx, New York, USA
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17
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Metabolic alterations in generalised anxiety disorder: a review of proton magnetic resonance spectroscopic studies. Epidemiol Psychiatr Sci 2017; 26:587-595. [PMID: 28789715 PMCID: PMC6998988 DOI: 10.1017/s2045796017000361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Generalised anxiety disorder (GAD) is a common psychiatric illness characterised by selective morpho-functional brain alterations. The breath of neuroimaging studies investigating the neural basis of GAD is extensive; however, its pathophysiology is still largely unknown. Specifically for proton Magnetic Resonance Spectroscopy (¹H MRS) investigations, which have the aim of identifying differences in metabolite levels between conditions in key brain areas, often showed contrasting results. Indeed, there are selected ¹H MRS studies reporting deficits of key metabolites in GAD patients; however, collectively the literature remains mixed with respect to consistency of major findings. In this review, we evaluate published ¹H MRS studies on GAD with the final aim of providing a comprehensive overview of the extent of neurometabolic dysfunctions associated with GAD. Interestingly, the majority of the studies reviewed showed altered metabolite levels in the dorsolateral prefrontal cortex and hippocampus suggesting regional specificity. These results also provide evidence of the utility of ¹H MRS not only for elucidating the pathophysiology of neuropsychiatric diseases, but also for the identification of more beneficial and targeted pharmacological interventions. Additionally, future studies are warranted to overcome methodological differences observed across the studies.
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18
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Natelson BH, Vu D, Coplan JD, Mao X, Blate M, Kang G, Soto E, Kapusuz T, Shungu DC. Elevations of Ventricular Lactate Levels Occur in Both Chronic Fatigue Syndrome and Fibromyalgia. FATIGUE-BIOMEDICINE HEALTH AND BEHAVIOR 2017; 5:15-20. [PMID: 29308330 DOI: 10.1080/21641846.2017.1280114] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Chronic fatigue syndrome (CFS) and fibromyalgia (FM) frequently have overlapping symptoms, leading to the suggestion that the same disease processes may underpin the two disorders - the unitary hypothesis. However, studies investigating the two disorders have reported substantial clinical and/or biological differences between them, suggesting distinct pathophysiological underpinnings. Purpose The purpose of this study was to further add to the body of evidence favoring different disease processes in CFS and FM by comparing ventricular cerebrospinal fluid lactate levels among patients with CFS alone, FM alone, overlapping CFS and FM symptoms, and healthy control subjects. Methods Ventricular lactate was assessed in vivo with proton magnetic resonance spectroscopic imaging (1H MRSI) with the results normed across the 2 studies in which the data were collected. Results Mean CSF lactate levels in CFS, FM and CFS+FM did not differ among the three groups, but were all significantly higher than the mean values for control subjects. Conclusion While patients with CFS, FM and comorbid CFS and FM can be differentiated from healthy subjects based on measures of CFS lactate, this neuroimaging outcome measure is not a viable biomarker for differentiating CFS from FM or from patients in whom symptoms of the two disorders overlap.
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Affiliation(s)
| | - Diana Vu
- Department of Neurology, Mount Sinai Beth Israel, New York, NY
| | - Jeremy D Coplan
- Department of Psychiatry & Behavioral Sciences, State University of New York-Downstate Medical Center, Brooklyn NY
| | - Xiangling Mao
- Department of Radiology, Weill Medical College of Cornell University, New York, NY
| | - Michelle Blate
- Department of Neurology, Mount Sinai Beth Israel, New York, NY
| | - Guoxin Kang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY
| | - Eli Soto
- Department of Pain Medicine, Mount Sinai Beth Israel, New York, NY
| | - Tolga Kapusuz
- Department of Pain Medicine, Mount Sinai Beth Israel, New York, NY
| | - Dikoma C Shungu
- Department of Radiology, Weill Medical College of Cornell University, New York, NY
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McElroy SL, Kemp DE, Friedman ES, Reilly-Harrington NA, Sylvia LG, Calabrese JR, Rabideau DJ, Ketter TA, Thase ME, Singh V, Tohen M, Bowden CL, Bernstein EE, Brody BD, Deckersbach T, Kocsis JH, Kinrys G, Bobo WV, Kamali M, McInnis MG, Leon AC, Faraone S, Nierenberg AA, Shelton RC. Obesity, but not metabolic syndrome, negatively affects outcome in bipolar disorder. Acta Psychiatr Scand 2016; 133:144-153. [PMID: 26114830 PMCID: PMC4844561 DOI: 10.1111/acps.12460] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Examine the effects of obesity and metabolic syndrome on outcome in bipolar disorder. METHOD The Comparative Effectiveness of a Second Generation Antipsychotic Mood Stabilizer and a Classic Mood Stabilizer for Bipolar Disorder (Bipolar CHOICE) study randomized 482 participants with bipolar disorder in a 6-month trial comparing lithium- and quetiapine-based treatment. Baseline variables were compared between groups with and without obesity, with and without abdominal obesity, and with and without metabolic syndrome respectively. The effects of baseline obesity, abdominal obesity, and metabolic syndrome on outcomes were examined using mixed effects linear regression models. RESULTS At baseline, 44.4% of participants had obesity, 48.0% had abdominal obesity, and 27.3% had metabolic syndrome; neither obesity, nor abdominal obesity, nor metabolic syndrome were associated with increased global severity, mood symptoms, or suicidality, or with poorer functioning or life satisfaction. Treatment groups did not differ on prevalence of obesity, abdominal obesity, or metabolic syndrome. By contrast, among the entire cohort, obesity was associated with less global improvement and less improvement in total mood and depressive symptoms, suicidality, functioning, and life satisfaction after 6 months of treatment. Abdominal obesity was associated with similar findings. Metabolic syndrome had no effect on outcome. CONCLUSION Obesity and abdominal obesity, but not metabolic syndrome, were associated with less improvement after 6 months of lithium- or quetiapine-based treatment.
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Affiliation(s)
- Susan L McElroy
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH and Lindner Center of HOPE, Mason, OH, USA
| | - David E Kemp
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Edward S Friedman
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Noreen A Reilly-Harrington
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Louisa G Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Dustin J Rabideau
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, USA
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael E Thase
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivek Singh
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Mauricio Tohen
- Department of Psychiatry, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Charles L Bowden
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Emily E Bernstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin D Brody
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - James H Kocsis
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Gustavo Kinrys
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Masoud Kamali
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Andrew C. Leon
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Stephen Faraone
- Department of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Richard C Shelton
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
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Raparia E, Coplan JD, Abdallah CG, Hof PR, Mao X, Mathew SJ, Shungu DC. Impact of childhood emotional abuse on neocortical neurometabolites and complex emotional processing in patients with generalized anxiety disorder. J Affect Disord 2016; 190:414-423. [PMID: 26551399 DOI: 10.1016/j.jad.2015.09.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/05/2015] [Accepted: 09/10/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The rostral prefrontal cortex (RPFC) is involved in reflective thought processes such as self-knowledge and person perception. We hypothesized that childhood emotional abuse, which is disruptive of emotional regulation, would differentially impact neurometabolite concentrations of the RPFC, and related neocortical areas, in adults with generalized anxiety disorder (GAD) versus healthy controls. METHODS GAD patients (n=16; females=11) and medically healthy volunteers (n=16; F=10) were assessed using the Childhood Trauma Questionnaire (CTQ), specifically the emotional abuse category. Proton magnetic resonance spectroscopy imaging examined 3 regions of interest (ROI) from the most rostral slice from the Duyn et al. (1993) multivoxel imaging modality: rostral prefrontal cortex (BA 10,9), premotor cortex (BA 6,8) and secondary somatosensory and associated parietal cortex (BA 5,7). Metabolites included N-acetyl-aspartate, creatine, and choline. RESULTS GAD patients reported higher emotional abuse scores versus controls. An omnibus general linear model including 3 ROI, 3 metabolites, and laterality as dependent variables revealed a significant diagnosis by CTQ emotional abuse score interactive effect. In controls, all 3 ROI for all 3 metabolites on both sides demonstrated a significant inverse relationship with emotional abuse scores; none were significant in GAD patients. LIMITATIONS A major limitation is the uneven distribution of emotional abuse scores between the controls and GAD patients, with GAD patients reporting higher scores. CONCLUSION Unlike controls, GAD patients appear compromised in forming a molecular representation reflective of magnitude of childhood emotional abuse. The neurometabolites in GAD patients appear non-aligned to childhood emotional abuse, suggesting potential consequences for normative "theory of mind" processes and emotional function in certain anxiety disorders.
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Affiliation(s)
- Eva Raparia
- College of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
| | - Jeremy D Coplan
- Department of Psychiatry & Behavioral Sciences, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Patrick R Hof
- Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiangling Mao
- Departments of Radiology, Psychiatry and Biophysics, Weill Medical College of Cornell University, New York, NY, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. Debakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Dikoma C Shungu
- Departments of Radiology, Psychiatry and Biophysics, Weill Medical College of Cornell University, New York, NY, USA
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Archer T, Kostrzewa RM. Physical Exercise Alleviates Health Defects, Symptoms, and Biomarkers in Schizophrenia Spectrum Disorder. Neurotox Res 2015; 28:268-80. [PMID: 26174041 DOI: 10.1007/s12640-015-9543-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/08/2015] [Accepted: 07/06/2015] [Indexed: 02/07/2023]
Abstract
Schizophrenia spectrum disorders are characterized by symptom profiles consisting of positive and negative symptoms, cognitive impairment, and a plethora of genetic, epigenetic, and phenotypic biomarkers. Assorted animal models of these disorders and clinical neurodevelopmental indicators have implicated neurodegeneration as an element in the underlying pathophysiology. Physical exercise or activity regimes--whether aerobic, resistance, or endurance--ameliorate regional brain and functional deficits not only in affected individuals but also in animal models of the disorder. Cognitive deficits, often linked to regional deficits, were alleviated by exercise, as were quality-of-life, independent of disorder staging and risk level. Apoptotic processes intricate to the etiopathogenesis of schizophrenia were likewise attenuated by physical exercise. There is also evidence of manifest benefits endowed by physical exercise in preserving telomere length and integrity. Not least, exercise improves overall health and quality-of-life. The notion of scaffolding as the outcome of physical exercise implies the "buttressing" of regional network circuits, neurocognitive domains, anti-inflammatory defenses, maintenance of telomeric integrity, and neuro-reparative and regenerative processes.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, 405 30, Gothenburg, Sweden,
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Glucagon-like peptide-1 as predictor of body mass index and dentate gyrus neurogenesis: neuroplasticity and the metabolic milieu. Neural Plast 2014; 2014:917981. [PMID: 25506432 PMCID: PMC4259073 DOI: 10.1155/2014/917981] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 01/22/2023] Open
Abstract
Glucagon-like peptide-1 (GLP-1) regulates carbohydrate metabolism and promotes neurogenesis. We reported an inverse correlation between adult body mass and neurogenesis in nonhuman primates. Here we examine relationships between physiological levels of the neurotrophic incretin, plasma GLP-1 (pGLP-1), and body mass index (BMI) in adolescence to adult neurogenesis and associations with a diabesity diathesis and infant stress. Morphometry, fasting pGLP-1, insulin resistance, and lipid profiles were measured in early adolescence in 10 stressed and 4 unstressed male bonnet macaques. As adults, dentate gyrus neurogenesis was assessed by doublecortin staining. High pGLP-1, low body weight, and low central adiposity, yet peripheral insulin resistance and high plasma lipids, during adolescence were associated with relatively high adult neurogenesis rates. High pGLP-1 also predicted low body weight with, paradoxically, insulin resistance and high plasma lipids. No rearing effects for neurogenesis rates were observed. We replicated an inverse relationship between BMI and neurogenesis. Adolescent pGLP-1 directly predicted adult neurogenesis. Two divergent processes relevant to human diabesity emerge—high BMI, low pGLP-1, and low neurogenesis and low BMI, high pGLP-1, high neurogenesis, insulin resistance, and lipid elevations. Diabesity markers putatively reflect high nutrient levels necessary for neurogenesis at the expense of peripheral tissues.
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