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Schindler LS, Subramaniapillai S, Ambikairajah A, Barth C, Crestol A, Voldsbekk I, Beck D, Gurholt TP, Topiwala A, Suri S, Ebmeier KP, Andreassen OA, Draganski B, Westlye LT, de Lange AMG. Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later. Front Glob Womens Health 2023; 4:1320640. [PMID: 38213741 PMCID: PMC10783171 DOI: 10.3389/fgwh.2023.1320640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
Introduction The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology. Methods In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40-70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline. Results Postmenopausal females showed higher levels of baseline blood lipids (HDL β = 0.14, p < 0.001, LDL β = 0.20, p < 0.001, triglycerides β = 0.12, p < 0.001) and HbA1c (β = 0.24, p < 0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group (β = -0.08, p < 0.001), while WHR increased to a similar extent in both groups (β = -0.03, p = 0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes (β range = 0.03-0.13, p ≤ 0.002). HDL showed a significant inverse relationship with WMH volume (β = -0.27, p < 0.001). Discussion Our findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.
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Affiliation(s)
- Louise S. Schindler
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sivaniya Subramaniapillai
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ananthan Ambikairajah
- Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Irene Voldsbekk
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dani Beck
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tiril P. Gurholt
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anya Topiwala
- Nuffield Department Population Health, Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Klaus P. Ebmeier
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Bogdan Draganski
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lars T. Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ann-Marie G. de Lange
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Abstract
Menopause nomenclature varies in the scholarly literature making synthesis and interpretation of research findings difficult. Therefore, the present study aimed to review and discuss critical developments in menopause nomenclature; determine the level of heterogeneity amongst menopause definitions and compare them with the Stages of Reproductive Aging Workshop criteria. Definitions/criteria used to characterise premenopausal and postmenopausal status were extracted from 210 studies and 128 of these studies were included in the final analyses. The main findings were that 39.84% of included studies were consistent with STRAW classification of premenopause, whereas 70.31% were consistent with STRAW classification of postmenopause. Surprisingly, major inconsistencies relating to premenopause definition were due to a total lack of reporting of any definitions/criteria for premenopause (39.84% of studies). In contrast, only 20.31% did not report definitions/criteria for postmenopause. The present findings indicate that there is a significant amount of heterogeneity associated with the definition of premenopause, compared with postmenopause. We propose three key suggestions/recommendations, which can be distilled from these findings. Firstly, premenopause should be transparently operationalised and reported. Secondly, as a minimum requirement, regular menstruation should be defined as the number of menstrual cycles in a period of at least 3 months. Finally, the utility of introducing normative age-ranges as supplementary criterion for defining stages of reproductive ageing should be considered. The use of consistent terminology in research will enhance our capacity to compare results from different studies and more effectively investigate issues related to women's health and ageing.
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Affiliation(s)
- Ananthan Ambikairajah
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia.
- Discipline of Psychology, Faculty of Health, University of Canberra, Building 12, 11 Kirinari Street, Canberra, ACT, 2617, Australia.
| | - Erin Walsh
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia
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Schindler LS, Subramaniapillai S, Barth C, van der Meer D, Pedersen ML, Kaufmann T, Maximov II, Linge J, Leinhard OD, Beck D, Gurholt TP, Voldsbekk I, Suri S, Ebmeier KP, Draganski B, Andreassen OA, Westlye LT, de Lange AMG. Associations between abdominal adipose tissue, reproductive span, and brain characteristics in post-menopausal women. Neuroimage Clin 2022; 36:103239. [PMID: 36451350 PMCID: PMC9668664 DOI: 10.1016/j.nicl.2022.103239] [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: 07/26/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
The menopause transition involves changes in oestrogens and adipose tissue distribution, which may influence female brain health post-menopause. Although increased central fat accumulation is linked to risk of cardiometabolic diseases, adipose tissue also serves as the primary biosynthesis site of oestrogens post-menopause. It is unclear whether different types of adipose tissue play diverging roles in female brain health post-menopause, and whether this depends on lifetime oestrogen exposure, which can have lasting effects on the brain and body even after menopause. Using the UK Biobank sample, we investigated associations between brain characteristics and visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (ASAT) in 10,251 post-menopausal females, and assessed whether the relationships varied depending on length of reproductive span (age at menarche to age at menopause). To parse the effects of common genetic variation, we computed polygenic scores for reproductive span. The results showed that higher VAT and ASAT were both associated with higher grey and white matter brain age, and greater white matter hyperintensity load. The associations varied positively with reproductive span, indicating more prominent associations between adipose tissue and brain measures in females with a longer reproductive span. The effects were in general small, but could not be fully explained by genetic variation or relevant confounders. Our findings indicate that associations between abdominal adipose tissue and brain health post-menopause may partly depend on individual differences in cumulative oestrogen exposure during reproductive years, emphasising the complexity of neural and endocrine ageing processes in females.
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Affiliation(s)
- Louise S Schindler
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychology, University of Oslo, Oslo, Norway.
| | - Sivaniya Subramaniapillai
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychology, University of Oslo, Oslo, Norway
| | - Claudia Barth
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Dennis van der Meer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; School of Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, The Netherlands
| | - Mads L Pedersen
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry and Psychotherapy, University of Tübingen, Germany
| | - Ivan I Maximov
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jennifer Linge
- AMRA Medical AB, Linköping, Sweden; Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Olof Dahlqvist Leinhard
- AMRA Medical AB, Linköping, Sweden; Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Dani Beck
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tiril P Gurholt
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Irene Voldsbekk
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | | | - Bogdan Draganski
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Dept. of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychiatry, University of Oxford, Oxford, UK
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Effect of overweight and obesity on cognitive function in children from 8 to 12 years of age: a descriptive study with a cross-sectional design. NUTR HOSP 2021; 38:690-696. [PMID: 34092076 DOI: 10.20960/nh.03474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introducción: el sobrepeso y la obesidad en la infancia y la adolescencia se han incrementado progresivamente durante los últimos años. Además de las comorbilidades conocidas, la obesidad se ha relacionado con un bajo rendimiento escolar en todas las edades, asociándose a alteraciones cognitivas. Objetivo: determinar la diferencia que existe en la función cognitiva de unos niños de 8 a 12 años con normopeso, sobrepeso u obesidad. Material y métodos: se realizó un estudio observacional y transversal en 46 niños de 8 a 12 años. Los niños se clasificaron en 3 grupos: normopeso, sobrepeso y obesidad. Posteriormente se realizaron pruebas de función cognitiva. Resultados: la mayoría de los niños con obesidad presentaron deterioro cognitivo (63 %; p = 0.02)), con mayor grado de deterioro en comparación con el observado en los demás grupos (80 %; p < 0.05). Por otro lado se observó que los niños con sobrepeso aún tienen posibilidad de evitar el desarrollo del padecimiento si corrigen sus hábitos, ya que los resultados de este grupo fueron similares a los del grupo con normopeso. Conclusiones: encontramos un incremento significativo no solo del déficit cognitivo sino también del grado de severidad de este en los niños obesos en comparación con aquellos con sobrepeso o normopeso.
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Goldstein BI, Baune BT, Bond DJ, Chen P, Eyler L, Fagiolini A, Gomes F, Hajek T, Hatch J, McElroy SL, McIntyre RS, Prieto M, Sylvia LG, Tsai S, Kcomt A, Fiedorowicz JG. Call to action regarding the vascular-bipolar link: A report from the Vascular Task Force of the International Society for Bipolar Disorders. Bipolar Disord 2020; 22:440-460. [PMID: 32356562 PMCID: PMC7522687 DOI: 10.1111/bdi.12921] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The association of bipolar disorder with early and excessive cardiovascular disease was identified over a century ago. Nonetheless, the vascular-bipolar link remains underrecognized, particularly with regard to how this link can contribute to our understanding of pathogenesis and treatment. METHODS An international group of experts completed a selective review of the literature, distilling core themes, identifying limitations and gaps in the literature, and highlighting future directions to bridge these gaps. RESULTS The association between bipolar disorder and vascular disease is large in magnitude, consistent across studies, and independent of confounding variables where assessed. The vascular-bipolar link is multifactorial and is difficult to study given the latency between the onset of bipolar disorder, often in adolescence or early adulthood, and subsequent vascular disease, which usually occurs decades later. As a result, studies have often focused on risk factors for vascular disease or intermediate phenotypes, such as structural and functional vascular imaging measures. There is interest in identifying the most relevant mediators of this relationship, including lifestyle (eg, smoking, diet, exercise), medications, and systemic biological mediators (eg, inflammation). Nonetheless, there is a paucity of treatment studies that deliberately engage these mediators, and thus far no treatment studies have focused on engaging vascular imaging targets. CONCLUSIONS Further research focused on the vascular-bipolar link holds promise for gleaning insights regarding the underlying causes of bipolar disorder, identifying novel treatment approaches, and mitigating disparities in cardiovascular outcomes for people with bipolar disorder.
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Affiliation(s)
- Benjamin I. Goldstein
- Centre for Youth Bipolar DisorderSunnybrook Health Sciences CentreTorontoONCanada,Departments of Psychiatry & PharmacologyFaculty of MedicineUniversity of TorontoTorontoONCanada
| | - Bernhard T. Baune
- Department of Psychiatry and PsychotherapyUniversity of MünsterMünsterGermany,Department of PsychiatryMelbourne Medical SchoolThe University of MelbourneMelbourneVICAustralia,The Florey Institute of Neuroscience and Mental HealthThe University of MelbourneParkvilleVICAustralia
| | - David J. Bond
- Department of Psychiatry and Behavioral ScienceUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Pao‐Huan Chen
- Department of PsychiatryTaipei Medical University HospitalTaipeiTaiwan,Department of PsychiatrySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Lisa Eyler
- Department of PsychiatryUniversity of California San DiegoSan DiegoCAUSA
| | | | - Fabiano Gomes
- Department of PsychiatryQueen’s University School of MedicineKingstonONCanada
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada,National Institute of Mental HealthKlecanyCzech Republic
| | - Jessica Hatch
- Centre for Youth Bipolar DisorderSunnybrook Health Sciences CentreTorontoONCanada,Departments of Psychiatry & PharmacologyFaculty of MedicineUniversity of TorontoTorontoONCanada
| | - Susan L. McElroy
- Department of Psychiatry and Behavioral NeuroscienceUniversity of Cincinnati College of MedicineCincinnatiOHUSA,Lindner Center of HOPEMasonOHUSA
| | - Roger S. McIntyre
- Departments of Psychiatry & PharmacologyFaculty of MedicineUniversity of TorontoTorontoONCanada,Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada
| | - Miguel Prieto
- Department of PsychiatryFaculty of MedicineUniversidad de los AndesSantiagoChile,Mental Health ServiceClínica Universidad de los AndesSantiagoChile,Department of Psychiatry and PsychologyMayo Clinic College of Medicine and ScienceRochesterMNUSA
| | - Louisa G. Sylvia
- Department of PsychiatryMassachusetts General HospitalBostonMAUSA,Department of PsychiatryHarvard Medical SchoolCambridgeMAUSA
| | - Shang‐Ying Tsai
- Department of PsychiatryTaipei Medical University HospitalTaipeiTaiwan,Department of PsychiatrySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Andrew Kcomt
- Hope+Me—Mood Disorders Association of OntarioTorontoONCanada
| | - Jess G. Fiedorowicz
- Departments of Psychiatry, Internal Medicine, & EpidemiologyCarver College of MedicineUniversity of IowaIowa CityIAUSA
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Abstract
OBJECTIVE This study aimed to investigate the relationship between waist circumference as a measure of abdominal obesity and brain responses to stress among patients with coronary artery disease (CAD). METHODS Patients with CAD (N = 151) underwent acute mental stress tasks in conjunction with high-resolution positron emission tomography and radiolabeled water imaging of the brain. Brain responses to mental stress were correlated with waist circumference. RESULTS Waist circumference was positively correlated with increased activation in the right and left frontal lobes (β values ranging from 2.81 to 3.75 in the paracentral, medial, and superior gyri), left temporal lobe, left hippocampal, left amygdala, left uncus, and left anterior and posterior cingulate gyri (β values ranging from 2.93 to 3.55). Waist circumference was also negatively associated with the left and right parietal lobes, right superior temporal gyrus, and right insula and precuneus (β values ranging from 2.82 to 5.20). CONCLUSION Increased brain activation in the brain regions involved in the stress response and autonomic regulation of the cardiovascular system during psychological stress may underlie stress-induced overeating and abdominal obesity in patients with CAD.
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Huang Y, Li X, Jackson T, Chen S, Meng J, Qiu J, Chen H. Interaction Effect of Sex and Body Mass Index on Gray Matter Volume. Front Hum Neurosci 2019; 13:360. [PMID: 31680912 PMCID: PMC6811608 DOI: 10.3389/fnhum.2019.00360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/26/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: Few studies have investigated sex differences in brain structure associated with body mass index (BMI), and the related findings are inconsistent. In this study, we aimed to investigate the effect of sex × BMI interactions on gray matter volume (GMV), and to determine the implications of any structural differences. Methods: The final sample comprised 653 participants (449 women) who were assessed using voxel-based morphology analysis of T1-weighted magnetic resonance images. We used the voxel-based morphometry (VBM) to build a multiple regression model to explore the association between BMI and GMV, and used analysis of variance (ANOVA) to explore the BMI × sex interaction on GMV. A subset of 410 participants (291 women) underwent whole brain resting-state functional connectivity (rsFC) analysis to investigate sex differences in the seed (interaction) region. The cluster with a significant effect in the previous ANOVA analysis was used as a seed. Results: A significant BMI × sex interaction was observed in the left anterior cingulate cortex (ACC), while GMV was negatively correlated with BMI in men but not in women. The rsFC between the left ACC and the caudate was lower in men than in women. Within the entire sample, the insula, caudate, and medial frontal cortex activities were negatively correlated with BMI while the cerebellum and postcentral gyrus activities were positively correlated with BMI. Conclusions: Our findings address the interaction effect of BMI and sex on GM alterations. We found that the GMV in men seemed to be more likely to change with BMI than women, and the left ACC may be the reason for the increase in BMI of men, but not women.
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Affiliation(s)
- Yufei Huang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Xianjie Li
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Todd Jackson
- Faculty of Psychology, Southwest University, Chongqing, China.,Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, China
| | - Shuaiyu Chen
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Jie Meng
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China
| | - Hong Chen
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China
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Ambikairajah A, Walsh E, Tabatabaei-Jafari H, Cherbuin N. Fat mass changes during menopause: a metaanalysis. Am J Obstet Gynecol 2019; 221:393-409.e50. [PMID: 31034807 DOI: 10.1016/j.ajog.2019.04.023] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/15/2019] [Accepted: 04/19/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Data: Fat mass has been shown to increase in aging women; however, the extent to which menopausal status mediates these changes remains unclear. The purpose of this review was to determine (1) how fat mass differs in quantity and distribution between premenopausal and postmenopausal women, (2) whether and how age and/or menopausal status moderates any observed differences, and (3) which type of fat mass measure is best suited to the detection of differences in fat mass between groups. STUDY This review with metaanalyses is reported according to Metaanalysis of Observational Studies in Epidemiology guidelines. STUDY APPRAISAL AND SYNTHESIS METHODS Studies (published up to May 2018) were identified via PubMed to provide fat mass measures in premenopausal and postmenopausal women. We included 201 cross-sectional studies in the metaanalysis, which provided a combined sample size of 1,049,919 individuals and consisted of 478,734 premenopausal women and 571,185 postmenopausal women. Eleven longitudinal studies were included in the metaanalyses, which provided a combined sample size of 2472 women who were premenopausal at baseline and postmenopausal at follow up. RESULTS The main findings of this review were that fat mass significantly increased between premenopausal and postmenopausal women across most measures, which included body mass index (1.14 kg/m2; 95% confidence interval, 0.95-1.32 kg/m2), bodyweight (1 kg; 95% confidence interval, 0.44-1.57 kg), body fat percentage (2.88%; 95% confidence interval, 2.13-3.63%), waist circumference (4.63 cm; 95% confidence interval, 3.90-5.35 cm), hip circumference (2.01 cm; 95% confidence interval, 1.36-2.65 cm), waist-hip ratio (0.04; 95% confidence interval, 0.03-0.05), visceral fat (26.90 cm2; 95% confidence interval, 13.12-40.68), and trunk fat percentage (5.49%; 95% confidence interval, 3.91-7.06 cm2). The exception was total leg fat percentage, which significantly decreased (-3.19%; 95% confidence interval, -5.98 to -0.41%). No interactive effects were observed between menopausal status and age across all fat mass measures. CONCLUSION The change in fat mass quantity between premenopausal and postmenopausal women was attributable predominantly to increasing age; menopause had no significant additional influence. However, the decrease in total leg fat percentage and increase in measures of central fat are indicative of a possible change in fat mass distribution after menopause. These changes are likely to, at least in part, be due to hormonal shifts that occur during midlife when women have a higher androgen (ie, testosterone) to estradiol ratio after menopause, which has been linked to enhanced central adiposity deposition. Evidently, these findings suggest attention should be paid to the accumulation of central fat after menopause, whereas increases in total fat mass should be monitored consistently across the lifespan.
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Alfaro FJ, Gavrieli A, Saade-Lemus P, Lioutas VA, Upadhyay J, Novak V. White matter microstructure and cognitive decline in metabolic syndrome: a review of diffusion tensor imaging. Metabolism 2018; 78:52-68. [PMID: 28920863 PMCID: PMC5732847 DOI: 10.1016/j.metabol.2017.08.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome is a cluster of cardiovascular risk factors defined by the presence of abdominal obesity, glucose intolerance, hypertension and/or dyslipidemia. It is a major public health epidemic worldwide, and a known risk factor for the development of cognitive dysfunction and dementia. Several studies have demonstrated a positive association between the presence of metabolic syndrome and worse cognitive outcomes, however, evidence of brain structure pathology is limited. Diffusion tensor imaging has offered new opportunities to detect microstructural white matter changes in metabolic syndrome, and a possibility to detect associations between functional and structural abnormalities. This review analyzes the impact of metabolic syndrome on white matter microstructural integrity, brain structure abnormalities and their relationship to cognitive function. Each of the metabolic syndrome components exerts a specific signature of white matter microstructural abnormalities. Metabolic syndrome and its components exert both additive/synergistic, as well as, independent effects on brain microstructure thus accelerating brain aging and cognitive decline.
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Affiliation(s)
- Freddy J Alfaro
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Anna Gavrieli
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Patricia Saade-Lemus
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Vasileios-Arsenios Lioutas
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Jagriti Upadhyay
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215,USA.
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
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Stillman CM, Weinstein AM, Marsland AL, Gianaros PJ, Erickson KI. Body-Brain Connections: The Effects of Obesity and Behavioral Interventions on Neurocognitive Aging. Front Aging Neurosci 2017; 9:115. [PMID: 28507516 PMCID: PMC5410624 DOI: 10.3389/fnagi.2017.00115] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/10/2017] [Indexed: 01/22/2023] Open
Abstract
Obesity is a growing public health problem in the United States, particularly in middle-aged and older adults. Although the key factors leading to a population increase in body weight are still under investigation, there is evidence that certain behavioral interventions can mitigate the negative cognitive and brain ("neurocognitive") health consequences of obesity. The two primary behaviors most often targeted for weight loss are caloric intake and physical activity. These behaviors might have independent, as well as overlapping/synergistic effects on neurocognitive health. To date obesity is often described independently from behavioral interventions in regards to neurocognitive outcomes, yet there is conceptual and mechanistic overlap between these constructs. This review summarizes evidence linking obesity and modifiable behaviors, such as physical activity and diet, with brain morphology (e.g., gray and white matter volume and integrity), brain function (e.g., functional activation and connectivity), and cognitive function across the adult lifespan. In particular, we review evidence bearing on the following question: Are associations between obesity and brain health in aging adults modifiable by behavioral interventions?
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Affiliation(s)
| | - Andrea M. Weinstein
- Department of Behavioral and Community and Health Sciences, University of PittsburghPittsburgh, PA, USA
| | - Anna L. Marsland
- Department of Psychology, University of PittsburghPittsburgh, PA, USA
| | - Peter J. Gianaros
- Department of Psychology, University of PittsburghPittsburgh, PA, USA
| | - Kirk I. Erickson
- Department of Psychiatry, University of PittsburghPittsburgh, PA, USA
- Department of Psychology, University of PittsburghPittsburgh, PA, USA
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Mazza E, Poletti S, Bollettini I, Locatelli C, Falini A, Colombo C, Benedetti F. Body mass index associates with white matter microstructure in bipolar depression. Bipolar Disord 2017; 19:116-127. [PMID: 28418197 DOI: 10.1111/bdi.12484] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 03/06/2017] [Accepted: 03/12/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Obesity has been reported in over 60% of bipolar disorder (BD) patients. It worsens the severity of illness, and influences cognition and functional outcomes. White matter (WM) abnormalities are one of the most consistently reported findings in neuroimaging studies of BD. We hypothesized that body mass index (BMI) could correlate with WM integrity in bipolar patients. METHODS We evaluated BMI in a sample of 164 depressed patients affected by BD. We performed whole-brain tract-based spatial statistics with threshold-free cluster enhancement for the diffusion tensor imaging (DTI) measures of WM integrity: fractional anisotropy; axial, radial, and mean diffusivity. RESULTS We observed that BMI was associated with DTI measures of WM integrity in several fiber tracts: anterior corona radiata, anterior thalamic radiation, inferior fronto-occipital fasciculus and corpus callosum. CONCLUSIONS The association of BMI in key WM tracts that are crucial to mood regulation and neurocognitive functioning suggests that BMI might contribute to the pathophysiology of BD through a detrimental action on structural connectivity in critical cortico-limbic networks.
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Affiliation(s)
- Elena Mazza
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Clara Locatelli
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Falini
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.,Department of Neuroradiology, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Cristina Colombo
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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12
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Khan NA, Raine LB, Donovan SM, Hillman CH. IV. The cognitive implications of obesity and nutrition in childhood. Monogr Soc Res Child Dev 2015; 79:51-71. [PMID: 25387415 DOI: 10.1111/mono.12130] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The prevalence of childhood obesity in the United States has tripled since the 1980s and is strongly linked to the early onset of several metabolic diseases. Recent studies indicate that lower cognitive function may be another complication of childhood obesity. This review considers the research to date on the role of obesity and nutrition on childhood cognition and brain health. Although a handful of studies point to a maladaptive relationship between obesity and aspects of cognitive control, remarkably little is known regarding the impact of fat mass on brain development and cognitive function. Further, missing from the literature is the role of nutrition in the obesity-cognition interaction. Nutrition may directly or indirectly influence cognitive performance via several pathways including provision of key substrates for optimal brain health, modulation of gut microbiota, and alterations in systemic energy balance. However, in the absence of malnutrition, the functional benefits of specific nutrient intake on particular cognitive domains are not well characterized. Here, we examine the literature linking childhood obesity and cognition while considering the effects of nutritional intake. Possible mechanisms for these relationships are discussed and suggestions are made for future study topics. Although childhood obesity prevalence rates in some developed countries have recently stabilized, significant disparities remain among groups based on sex and socioeconomic status. Given that the elevated prevalence of pediatric overweight and obesity may persist for the foreseeable future, it is crucial to develop a comprehensive understanding of the influence of obesity and nutrition on cognition and brain health in the pediatric population.
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13
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Willette AA, Kapogiannis D. Does the brain shrink as the waist expands? Ageing Res Rev 2015; 20:86-97. [PMID: 24768742 DOI: 10.1016/j.arr.2014.03.007] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/25/2014] [Accepted: 03/28/2014] [Indexed: 12/20/2022]
Abstract
Recent studies suggest that being overweight or obese is related to worse cognitive performance, particularly executive function. Obesity may also increase the risk of Alzheimer's disease. Consequently, there has been increasing interest in whether adiposity is related to gray or white matter (GM, WM) atrophy. In this review, we identified and critically evaluated studies assessing obesity and GM or WM volumes either globally or in specific regions of interest (ROIs). Across all ages, higher adiposity was consistently associated with frontal GM atrophy, particularly in prefrontal cortex. In children and adults <40 years of age, most studies found no relationship between adiposity and occipital or parietal GM volumes, whereas findings for temporal lobe were mixed. In middle-aged and aged adults, a majority of studies found that higher adiposity is associated with parietal and temporal GM atrophy, whereas results for precuneus, posterior cingulate, and hippocampus were mixed. Higher adiposity had no clear association with global or regional WM in any age group. We conclude that higher adiposity may be associated with frontal GM atrophy across all ages and parietal and temporal GM atrophy in middle and old age.
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Affiliation(s)
- Auriel A Willette
- Laboratory of Neurosciences, National Institute on Aging, 3001 S. Hanover St, NM531, Baltimore, MD 21225, USA
| | - Dimitrios Kapogiannis
- Laboratory of Neurosciences, National Institute on Aging, 3001 S. Hanover St, NM531, Baltimore, MD 21225, USA.
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Magierski R, Kłoszewska I, Sobow T. Evaluation of the influence of metabolic processes and body composition on cognitive functions: Nutrition and Dementia Project (NutrDem Project). Eur J Clin Nutr 2014; 68:1200-3. [DOI: 10.1038/ejcn.2014.171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 07/12/2014] [Indexed: 01/27/2023]
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Veijola J, Guo JY, Moilanen JS, Jääskeläinen E, Miettunen J, Kyllönen M, Haapea M, Huhtaniska S, Alaräisänen A, Mäki P, Kiviniemi V, Nikkinen J, Starck T, Remes JJ, Tanskanen P, Tervonen O, Wink AM, Kehagia A, Suckling J, Kobayashi H, Barnett JH, Barnes A, Koponen HJ, Jones PB, Isohanni M, Murray GK. Longitudinal changes in total brain volume in schizophrenia: relation to symptom severity, cognition and antipsychotic medication. PLoS One 2014; 9:e101689. [PMID: 25036617 PMCID: PMC4103771 DOI: 10.1371/journal.pone.0101689] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 06/11/2014] [Indexed: 02/07/2023] Open
Abstract
Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population based birth cohort sample in a relatively long follow-up period of almost a decade. All members of the Northern Finland Birth Cohort 1966 with any psychotic disorder and a random sample not having psychosis were invited for a MRI brain scan, and clinical and cognitive assessment during 1999-2001 at the age of 33-35 years. A follow-up was conducted 9 years later during 2008-2010. Brain scans at both time points were obtained from 33 participants with schizophrenia and 71 control participants. Regression models were used to examine whether brain volume changes predicted clinical and cognitive changes over time, and whether antipsychotic medication predicted brain volume changes. The mean annual whole brain volume reduction was 0.69% in schizophrenia, and 0.49% in controls (p = 0.003, adjusted for gender, educational level, alcohol use and weight gain). The brain volume reduction in schizophrenia patients was found especially in the temporal lobe and periventricular area. Symptom severity, functioning level, and decline in cognition were not associated with brain volume reduction in schizophrenia. The amount of antipsychotic medication (dose years of equivalent to 100 mg daily chlorpromazine) over the follow-up period predicted brain volume loss (p = 0.003 adjusted for symptom level, alcohol use and weight gain). In this population based sample, brain volume reduction continues in schizophrenia patients after the onset of illness, and antipsychotic medications may contribute to these reductions.
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Affiliation(s)
- Juha Veijola
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- * E-mail:
| | - Joyce Y. Guo
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Jani S. Moilanen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Erika Jääskeläinen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Merja Kyllönen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Marianne Haapea
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Sanna Huhtaniska
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Antti Alaräisänen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Juha Nikkinen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Tuomo Starck
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jukka J. Remes
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Päivikki Tanskanen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Osmo Tervonen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Alle-Meije Wink
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- VU University Medical Centre, Department of Radiology, Amsterdam, The Netherlands
| | - Angie Kehagia
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, United Kingdom
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Hiroyuki Kobayashi
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Department of Neuropsychiatry, School of Medicine, Toho University, Tokyo, Japan
| | - Jennifer H. Barnett
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Cambridge Cognition Ltd, Bottisham, Cambridge, United Kingdom
| | - Anna Barnes
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Hannu J. Koponen
- University of Eastern Finland, Faculty of Health Sciences, Institute of Clinical Medicine and Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Matti Isohanni
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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16
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Glucose impairment and ghrelin gene variants are associated to cognitive dysfunction. Aging Clin Exp Res 2014; 26:161-9. [PMID: 24619886 DOI: 10.1007/s40520-014-0203-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 09/10/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Cognitive state and brain volume have been related to body mass index, abdominal fat, waist-hip ratio, components of metabolic syndrome (MS) and ghrelin. Genetic variations within the ghrelin gene have been recently associated to MS. The aim of our study was to investigate cognitive state by Mini-Mental State Examination (MMSE) in relation to MS components (ATP-III criteria) and ghrelin gene polymorphisms in dwelling individuals aged ≥70. METHODS 280 subjects (137 men/143 women, age 77.03 ± 5.92) from the Mataró Ageing Study were included. Individuals were phenotypically characterized by anthropometric variables, lipids, glucose, blood pressure and MMSE. SNPs -501AC (rs26802), -994CT (rs26312), -604GA (rs27647), M72L (rs696217) and L90G (rs4684677) of the ghrelin gene were studied. Genotypes were determined by polymerase chain reaction and SNapshot minisequencing. RESULTS 22.1 % had MMSE <24. MMSE <24 was associated with age (p < 0.001), female gender (p = 0.016), low education (p < 0.001) and glucose impairment or diabetes (p = 0.040). MMSE was influenced by obesity, central obesity, MS and glucose impairment. This latter association remained significant after adjustment by gender, age, alcohol, educational level, GDS and ApoE genotype (p = 0.009). Ghrelin SNPs were associated to MMSE: M72L C/A genotype showed lower score than C/C (p = 0.032, after adjusting for confounders 0.049); L90G A/T genotype showed lower score than A/A (p = 0.054, after adjusting 0.005). MMSE <24 was associated to L90G (39.1 % in A/T genotype vs 19.3 % in A/A, p = 0.026, after adjusting for confounders p = 0.002, OR 6.18 CI 1.93-21.75). CONCLUSIONS Glucose impairment and L90G Ghrelin gene variant influence cognitive function in old dwelling individuals participating in the Mataró Ageing Study.
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Kuswanto CN, Sum MY, Yang GL, Nowinski WL, McIntyre RS, Sim K. Increased body mass index makes an impact on brain white-matter integrity in adults with remitted first-episode mania. Psychol Med 2014; 44:533-541. [PMID: 23731622 DOI: 10.1017/s0033291713000858] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Obesity is increasingly prevalent in bipolar disorder (BD) but data about the impact of elevated body mass index (BMI) on brain white-matter integrity in BD are sparse. Based on extant literature largely from structural magnetic resonance imaging (MRI) studies, we hypothesize that increased BMI is associated with decreased fractional anisotropy (FA) in the frontal, temporal, parietal and occipital brain regions early in the course of BD. METHOD A total of 26 euthymic adults (12 normal weight and 14 overweight/obese) with remitted first-episode mania (FEM) and 28 controls (13 normal weight and 15 overweight/obese) matched for age, handedness and years of education underwent structural MRI and diffusion tensor imaging scans. RESULTS There are significant effects of diagnosis by BMI interactions observed especially in the right parietal lobe (adjusted F(1,48) = 5.02, p = 0.030), occipital lobe (adjusted F(1,48) = 10.30, p = 0.002) and temporal lobe (adjusted F(1,48) = 7.92, p = 0.007). Specifically, decreased FA is found in the right parietal (F(1,48) = 5.864, p = 0.023) and occipital lobes (F(1,48) = 4.397, p = 0.047) within overweight/obese patients compared with normal-weight patients with FEM. Compared with overweight/obese controls, decreased FA is observed in right parietal (F(1,48) = 6.708, p = 0.015), temporal (F(1,48) = 10.751, p = 0.003) and occipital (F(1,48) = 9.531, p = 0.005) regions in overweight/obese patients with FEM. CONCLUSIONS Our findings suggest that increased BMI affects temporo-parietal-occipital brain white-matter integrity in FEM. This highlights the need to further elucidate the relationship between obesity and other neural substrates (including subcortical changes) in BD which may clarify brain circuits subserving the association between obesity and clinical outcomes in BD.
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Affiliation(s)
- C N Kuswanto
- Research Department, Institute of Mental Health, Singapore
| | - M Y Sum
- Research Department, Institute of Mental Health, Singapore
| | - G L Yang
- Biomedical Imaging Laboratory, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - W L Nowinski
- Biomedical Imaging Laboratory, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - R S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada
| | - K Sim
- Research Department, Institute of Mental Health, Singapore
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Rosano C, Chang YF, Kuller LH, Guralnik JM, Studenski SA, Aizenstein HJ, Gianaros PJ, Lopez OL, Longstreth WT, Newman AB. Long-term survival in adults 65 years and older with white matter hyperintensity: association with performance on the digit symbol substitution test. Psychosom Med 2013; 75:624-31. [PMID: 23886735 PMCID: PMC3809761 DOI: 10.1097/psy.0b013e31829c1df2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE White matter hyperintensity (WMH) confers increased mortality risk in patients with cardiovascular diseases. However, little is known about differences in survival times among adults 65 years and older who have WMH and live in the community. To characterize the factors that may reduce mortality risk in the presence of WMH, measures of race, sex, apolipoprotein E4, neuroimaging, and cardiometabolic, physiological, and psychosocial characteristics were examined, with a particular focus on information processing as measured by the Digit Symbol Substitution Test (DSST). METHODS Cox proportional models were used to estimate mortality risks in a cohort of 3513 adults (74.8 years, 58% women, 84% white) with WMH (0-9 points), DSST (0-90 points), risk factor assessment in 1992 to 1994, and data on mortality and incident stroke in 2009 (median follow-up [range] = 14.2 [0.5-18.1] years). RESULTS WMH predicted a 48% greater mortality risk (age-adjusted hazard ratio [HR; 95% confidence interval {CI}] for WMH >3 points = 1.48 [1.35-1.62]). This association was attenuated after adjustment for DSST (HR [CI] = 1.38 [1.27-1.51]) or lacunar infarcts (HR [CI] = 1.37 [1.25,1.50]) but not after adjustment for other factors. The interaction between DSST and WMH was significant (p = .011). In fully adjusted models stratified by WMH of 3 or higher, participants with DSST greater than or equal to median had a 34% lower mortality risk among those with WMH of 3 or higher (n = 532/1217) and a 28% lower mortality risk among those with WMH lower than 3 (n = 1364/2296), compared with participants with DSST less than median (HR [95% CI] = 0.66 [0.55-0.81] and 0.72 [0.62-0.83], respectively). CONCLUSIONS WMH is associated with increased long-term mortality risk in community-dwelling adults 65 years and older. The increased risk is attenuated for those with higher DSST. Assessment of cognitive function with DSST may improve risk stratification of individuals with WMH.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Bredin SSD, Warburton DER, Lang DJ. The health benefits and challenges of exercise training in persons living with schizophrenia: a pilot study. Brain Sci 2013; 3:821-48. [PMID: 24961427 PMCID: PMC4061848 DOI: 10.3390/brainsci3020821] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/03/2013] [Accepted: 05/07/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In addition to the hallmark cognitive and functional impairments mounting evidence indicates that schizophrenia is also associated with an increased risk for the development of secondary complications, in particular cardio-metabolic disease. This is thought to be the result of various factors including physical inactivity and the metabolic side effects of psychotropic medications. Therefore, non-pharmacological approaches to improving brain health, physical health, and overall well-being have been promoted increasingly. METHODS We report on the health-related physical fitness (body composition, blood pressure, heart rate, and aerobic fitness) and lipid profile of persons living with schizophrenia and effective means to address the challenges of exercise training in this population. RESULTS There was a markedly increased risk for cardio-metabolic disease in 13 persons living with schizophrenia (Age = 31 ± 7 years) including low aerobic fitness (76% ± 34% of predicted), reduced HDL (60% of cohort), elevated resting heart rate (80% of cohort), hypertension (40% of cohort), overweight and obesity (69% of cohort), and abdominal obesity (54% of cohort). Individualized exercise prescription (3 times/week) was well tolerated, with no incidence of adverse exercise-related events. The exercise adherence rate was 81% ± 21% (Range 48%-100%), and 69% of the participants were able to complete the entire exercise training program. Exercise training resulted in clinically important changes in physical activity, aerobic fitness, exercise tolerance, blood pressure, and body composition. CONCLUSION Persons living with schizophrenia appear to be at an increased risk for cardio-metabolic disease. An individualized exercise program has shown early promise for the treatment of schizophrenia and the various cognitive, functional, and physiological impairments that ultimately affect health and well-being.
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Affiliation(s)
- Shannon S D Bredin
- Cognitive and Functional Learning Laboratory, University of British Columbia, Vancouver V6T 1Z1, Canada.
| | - Darren E R Warburton
- Cognitive and Functional Learning Laboratory, University of British Columbia, Vancouver V6T 1Z1, Canada.
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver V6T 1Z1, Canada.
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Shimoji K, Abe O, Uka T, Yasmin H, Kamagata K, Asahi K, Hori M, Nakanishi A, Tamura Y, Watada H, Kawamori R, Aoki S. White matter alteration in metabolic syndrome: diffusion tensor analysis. Diabetes Care 2013; 36:696-700. [PMID: 23172976 PMCID: PMC3579365 DOI: 10.2337/dc12-0666] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We explored the regional pattern of white matter alteration in subjects with metabolic syndrome. We also investigated whether white matter alteration was correlated with BMI. RESEARCH DESIGN AND METHODS Seven middle-aged men with metabolic syndrome and seven without metabolic syndrome underwent diffusion tensor imaging with a 3T magnetic resonance imaging imager. We analyzed the fractional anisotropy (FA) values by using a tract-based spatial statistics technique (whole-brain analysis). We subsequently focused on measuring the mean FA values of the right inferior fronto-occipital fasciculus (IFOF) of all subjects by tract-specific analysis (regional brain analysis). We used a Pearson correlation coefficient to evaluate the relationship between BMI and mean FA values of the right IFOF. RESULTS In the whole-brain analysis, subjects with metabolic syndrome had significantly lower FA values than control subjects in part of the right external capsule (part of the right IFOF), the entire corpus callosum, and part of the deep white matter of the right frontal lobe. In the regional brain analysis, the mean FA value of the right IFOF was 0.41 ± 0.03 for subjects with metabolic syndrome and 0.44 ± 0.05 for control subjects. A significant negative correlation was observed between BMI and FA values in the right IFOF (r = -0.56, P < 0.04). CONCLUSIONS Our results show that microstructural white matter changes occur in patients with metabolic syndrome. FA values may be useful indices of white matter alterations in patients with metabolic syndrome.
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Affiliation(s)
- Keigo Shimoji
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
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Changes in vascular factors 28 years from midlife and late-life cortical thickness. Neurobiol Aging 2013; 34:100-9. [DOI: 10.1016/j.neurobiolaging.2012.07.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 07/08/2012] [Accepted: 07/18/2012] [Indexed: 11/21/2022]
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Rosano C, Marsland AL, Gianaros PJ. Maintaining brain health by monitoring inflammatory processes: a mechanism to promote successful aging. Aging Dis 2012; 3:16-33. [PMID: 22500269 PMCID: PMC3320802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/15/2011] [Accepted: 09/20/2011] [Indexed: 05/31/2023] Open
Abstract
Maintaining brain health promotes successful aging. The main determinants of brain health are the preservation of cognitive function and remaining free from structural and metabolic abnormalities, including loss of neuronal synapses, atrophy, small vessel disease and focal amyloid deposits visible by neuroimaging. Promising studies indicate that these determinants are to some extent modifiable, even among adults seventy years and older. Converging animal and human evidence further suggests that inflammation is a shared mechanism, contributing to both cognitive decline and abnormalities in brain structure and metabolism. Thus, inflammation may provide a target for intervention. Specifically, circulating inflammatory markers have been associated with declines in cognitive function and worsening of brain structural and metabolic characteristics. Additionally, it has been proposed that older brains are characterized by a sensitization to neuroinflammatory responses, even in the absence of overt disease. This increased propensity to central inflammation may contribute to poor brain health and premature brain aging. Still unknown is whether and how peripheral inflammatory factors directly contribute to decline of brain health. Human research is limited by the challenges of directly measuring neuroinflammation in vivo. This review assesses the role that inflammation may play in the brain changes that often accompany aging, focusing on relationships between peripheral inflammatory markers and brain health among well-functioning, community-dwelling adults seventy years and older. We propose that monitoring and maintaining lower levels of systemic and central inflammation among older adults could help preserve brain health and support successful aging. Hence, we also identify plausible ways and novel experimental study designs of maintaining brain health late in age through interventions that target the immune system.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Obesity and the ageing brain: could leptin play a role in neurodegeneration? Curr Gerontol Geriatr Res 2011; 2011:708154. [PMID: 22013440 PMCID: PMC3195276 DOI: 10.1155/2011/708154] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 08/15/2011] [Indexed: 01/19/2023] Open
Abstract
Obesity and ageing are both characteristics of the human population that are on the increase across the globe. It has long been established that ageing is the major risk factor for neurodegenerative conditions such as Alzheimer's disease, and it is becoming increasingly evident that obesity is another such factor. Leptin resistance or insensitivity has been uncovered as a cause of obesity, and in addition the leptin signalling system is less potent in the elderly. Taken together, these findings reveal that this molecule may be a link between neurodegeneration and obesity or ageing. It is now known that leptin has beneficial effects on both the survival and neurophysiology of the neurons that are lost in Alzheimer's disease suggesting that it may be an important research target in the quest for strategies to prevent, halt, or cure this condition.
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Cazettes F, Tsui WH, Johnson G, Steen RG, Convit A. Systematic differences between lean and obese adolescents in brain spin-lattice relaxation time: a quantitative study. AJNR Am J Neuroradiol 2011; 32:2037-42. [PMID: 21960489 DOI: 10.3174/ajnr.a2698] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Emerging evidence suggests that obese adolescents show changes in brain structure compared with lean adolescents. In addition, obesity impacts body development during adolescence. We tested a hypothesis that T1, a marker of brain maturation, can show brain differences associated with obesity. MATERIALS AND METHODS Adolescents similar in sex, family income, and school grade were recruited by using strict entry criteria. We measured brain T1 in 48 obese and 31 lean adolescents by quantitative MR imaging at 1.5T. We combined MPRAGE and inversion-recovery sequences with normalization to standard space and automated skull stripping to obtain T1 maps with a symmetric voxel volume of 1 mm(3). RESULTS Sex, income, triglycerides, total cholesterol, and fasting glucose did not differ between groups, but obese adolescents had significantly lower HDL, higher LDL, and higher fasting insulin levels than lean adolescents. Intracranial vault volume did not differ between groups, but obese adolescents had smaller intracranial vault-adjusted brain parenchymal volumes. Obese adolescents had 4 clusters (>100 contiguous voxels) of T1 relaxation that were significantly different (P < .005) from those in lean adolescents. Three of these clusters had longer T1s in obese adolescents (in the orbitofrontal and parietal regions), and 1 cluster had shorter T1s, compared with lean adolescents. CONCLUSIONS Our results suggest that obesity may have a significant impact on brain development, especially in the frontal and parietal lobes. It is unclear if these changes persist into adulthood or whether they indicate that obese subjects follow a different developmental trajectory during adolescence.
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Affiliation(s)
- F Cazettes
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
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25
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Bond DJ, Lang DJ, Noronha MM, Kunz M, Torres IJ, Su W, Honer WG, Lam RW, Yatham LN. The association of elevated body mass index with reduced brain volumes in first-episode mania. Biol Psychiatry 2011; 70:381-7. [PMID: 21497795 DOI: 10.1016/j.biopsych.2011.02.025] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 01/28/2011] [Accepted: 02/15/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Compared with normal-weight patients, obese patients with bipolar I disorder (BD) suffer more manic and depressive episodes and make more suicide attempts. In the general population, obesity is associated with reduced total brain volume (TBV) and gray matter volume (GMV), but the neurobiology of obesity in BD has not been investigated. METHODS We used magnetic resonance imaging to examine TBV, GMV, white matter volume (WMV), as well as frontal, parietal, occipital, and temporal lobe volumes, in 55 healthy subjects (17 overweight/obese and 38 normal weight) and 57 patients with BD following their first manic episode (20 overweight/obese and 37 normal weight). RESULTS Linear regression analyses demonstrated that when other predictors of brain volume were accounted for, increased body mass index (BMI) in healthy subjects was significantly associated with decreased TBV and GMV. In contrast, increased BMI in patients with BD was significantly associated with decreased WMV and temporal lobe volume, areas of known vulnerability in early BD. CONCLUSIONS This is the first published report to show a relationship between elevated BMI and reduced brain volumes in BD, or any psychiatric illness. Our results suggest that obesity is associated with unique neurobiological changes in BD. They further imply a possible biological mechanism underlying the association between obesity and a more severe illness course in BD.
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Affiliation(s)
- David J Bond
- Mood Disorders Centre, University of British Columbia, Vancouver, Canada
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26
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Abstract
The brain is the key organ of stress processes. It determines what individuals will experience as stressful, it orchestrates how individuals will cope with stressful experiences, and it changes both functionally and structurally as a result of stressful experiences. Within the brain, a distributed, dynamic, and plastic neural circuitry coordinates, monitors, and calibrates behavioral and physiological stress response systems to meet the demands imposed by particular stressors. These allodynamic processes can be adaptive in the short term (allostasis) and maladaptive in the long term (allostatic load). Critically, these processes involve bidirectional signaling between the brain and body. Consequently, allostasis and allostatic load can jointly affect vulnerability to brain-dependent and stress-related mental and physical health conditions. This review focuses on the role of brain plasticity in adaptation to, and pathophysiology resulting from, stressful experiences. It also considers interventions to prevent and treat chronic and prevalent health conditions via allodynamic brain mechanisms.
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Affiliation(s)
- Bruce S McEwen
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York 10065, USA.
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27
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Jennings JR, Mendelson DN, Muldoon MF, Ryan CM, Gianaros PJ, Raz N, Aizenstein H. Regional grey matter shrinks in hypertensive individuals despite successful lowering of blood pressure. J Hum Hypertens 2011; 26:295-305. [PMID: 21490622 PMCID: PMC3137674 DOI: 10.1038/jhh.2011.31] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective To determine whether reduction in brain grey matter volume associated with hypertension persisted or was remediated among hypertensive patients newly treated over the course of a year. Methods Forty-one hypertensive patients were assessed over the course of a one-year successful anti-hypertensive treatment. Brain areas identified previously in cross-sectional studies as differing in volume between hypertensive and normotensive individuals were examined with a semi-automated measurement technique (ALP, automated labeling pathway). Volumes of grey matter regions were computed at baseline and after a year of treatment and compared to archival data from normotensive individuals. Results Reductions in regional grey matter volume over the follow-up period were observed despite successful treatment of blood pressure. The comparison group of older, but normotensive individuals showed no significant changes over a year in the regions tested in the treated hypertensive group. Conclusions These novel results suggest that essential hypertension is associated with regional grey matter shrinkage and successful reduction of blood pressure may not completely counter that trend.
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Affiliation(s)
- J R Jennings
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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28
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Mueller K, Anwander A, Möller HE, Horstmann A, Lepsien J, Busse F, Mohammadi S, Schroeter ML, Stumvoll M, Villringer A, Pleger B. Sex-dependent influences of obesity on cerebral white matter investigated by diffusion-tensor imaging. PLoS One 2011; 6:e18544. [PMID: 21494606 PMCID: PMC3073967 DOI: 10.1371/journal.pone.0018544] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 03/03/2011] [Indexed: 01/29/2023] Open
Abstract
Several studies have shown that obesity is associated with changes in human brain function and structure. Since women are more susceptible to obesity than men, it seems plausible that neural correlates may also be different. However, this has not been demonstrated so far. To address this issue, we systematically investigated the brain's white matter (WM) structure in 23 lean to obese women (mean age 25.5 y, std 5.1 y; mean body mass index (BMI) 29.5 kg/m2, std 7.3 kg/m2) and 26 lean to obese men (mean age 27.1 y, std 5.0 y; mean BMI 28.8 kg/m2, std 6.8 kg/m2) with diffusion-weighted magnetic resonance imaging (MRI). There was no significant age (p>0.2) or BMI (p>0.7) difference between female and male participants. Using tract-based spatial statistics, we correlated several diffusion parameters including the apparent diffusion coefficient, fractional anisotropy (FA), as well as axial (λ∥) and radial diffusivity (λ⊥) with BMI and serum leptin levels. In female and male subjects, the putative axon marker λ∥ was consistently reduced throughout the corpus callosum, particularly in the splenium (r = −0.62, p<0.005). This suggests that obesity may be associated with axonal degeneration. Only in women, the putative myelin marker λ⊥ significantly increased with increasing BMI (r = 0.57, p<0.005) and serum leptin levels (r = 0.62, p<0.005) predominantly in the genu of the corpus callosum, suggesting additional myelin degeneration. Comparable structural changes were reported for the aging brain, which may point to accelerated aging of WM structure in obese subjects. In conclusion, we demonstrate structural WM changes related to an elevated body weight, but with differences between men and women. Future studies on obesity-related functional and structural brain changes should therefore account for sex-related differences.
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Affiliation(s)
- Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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Peters A, Bosy-Westphal A, Kubera B, Langemann D, Goele K, Later W, Heller M, Hubold C, Müller MJ. Why doesn't the brain lose weight, when obese people diet? Obes Facts 2011; 4:151-7. [PMID: 21577022 PMCID: PMC6444703 DOI: 10.1159/000327676] [Citation(s) in RCA: 23] [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] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE As has been shown recently, obesity is associated with brain volume deficits. We here used an interventional study design to investigate whether the brain shrinks after caloric restriction in obesity. To elucidate mechanisms of neuroprotection we assessed brain-pull competence, i.e. the brain's ability to properly demand energy from the body. METHODS In 52 normal-weight and 42 obese women (before and after ≈10% weight loss) organ masses of brain, liver and kidneys (magnetic resonance imaging), fat (air displacement plethysmography) and muscle mass (dual-energy X-ray absorptiometry) were assessed. Body metabolism was measured by indirect calorimetry. To investigate how energy is allocated between brain and body, we used reference data obtained in the field of comparative biology. We calculated the distance between each woman and a reference mammal of comparable size in a brain-body plot and named the distance 'encephalic measure'. To elucidate how the brain protects its mass, we measured fasting insulin, since 'cerebral insulin suppression' has been shown to function as a brain-pull mechanism. RESULTS Brain mass was equal in normal-weight and obese women (1,441.8 ± 14.6 vs. 1,479.2 ± 12.8 g; n.s.) and was unaffected by weight loss (1,483.8 ± 12.7 g; n.s.). In contrast, masses of muscle, fat, liver and kidneys decreased by 3-18% after weight loss (all p < 0.05). The encephalic measure was lower in obese than normal-weight women (5.8 ± 0.1 vs. 7.4 ± 0.1; p < 0.001). Weight loss increased the encephalic measure to 6.3 ± 0.1 (p < 0.001). Insulin concentrations were inversely related to the encephalic measure (r = -0.382; p < 0.001). CONCLUSION Brain mass is normal in obese women and is protected during caloric restriction. Our data suggest that neuroprotection during caloric restriction is mediated by a competent brain-pull exerting cerebral insulin suppression.
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Affiliation(s)
- Achim Peters
- Medical Clinic I, University of Lübeck, Lübeck, Germany.
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Cazettes F, Cohen JI, Yau PL, Talbot H, Convit A. Obesity-mediated inflammation may damage the brain circuit that regulates food intake. Brain Res 2010; 1373:101-9. [PMID: 21146506 DOI: 10.1016/j.brainres.2010.12.008] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/02/2010] [Accepted: 12/03/2010] [Indexed: 11/26/2022]
Abstract
Adiposity is associated with chronic low-grade systemic inflammation and increased inflammation in the hypothalamus, a key structure in feeding behavior. It remains unknown whether inflammation impacts other brain structures that regulate feeding behavior. We studied 44 overweight/obese and 19 lean individuals with MRI and plasma fibrinogen levels (marker of inflammation). We performed MRI-based segmentations of the medial and lateral orbitofrontal cortex (OFC) and hippocampal volumes. Gray matter (GM) volumes were adjusted for head size variability. We conducted logistic and hierarchical regressions to assess the association between fibrinogen levels and brain volumetric data. Using diffusion tensor imaging (DTI), we created apparent diffusion coefficient (ADC) maps and conducted voxelwise correlational analyses. Fibrinogen concentrations were higher among the overweight/obese (t[61] = -2.33, P = 0.023). Lateral OFC associated together with fibrinogen correctly classified those with excess of weight (accuracy = 76.2%, sensitivity = 95.5%, and specificity=31.6%). The lateral OFC volumes of overweight/obese were negatively associated with fibrinogen (r = -0.37, P = 0.016) and after accounting for age, hypertension, waist/hip ratio and lipid and sugar levels, fibrinogen significantly explained an additional 9% of the variance in the lateral OFC volume (β = -0.348, ΔR(2) = 0.093, ΔF P = 0.046). Among overweight/obese the associations between GM ADC and fibrinogen were significantly positive (P < 0.001) in the left and right amygdala and the right parietal region. Among lean individuals these associations were negative and located in the left prefrontal, the right parietal and the left occipital lobes. This is the first study to report that adiposity-related inflammation may reduce the integrity of some of the brain structures involved in reward and feeding behaviors.
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Affiliation(s)
- Fanny Cazettes
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.
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