1
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McWhinney SR, Hlinka J, Bakstein E, Dietze LMF, Corkum ELV, Abé C, Alda M, Alexander N, Benedetti F, Berk M, Bøen E, Bonnekoh LM, Boye B, Brosch K, Canales‐Rodríguez EJ, Cannon DM, Dannlowski U, Demro C, Diaz‐Zuluaga A, Elvsåshagen T, Eyler LT, Fortea L, Fullerton JM, Goltermann J, Gotlib IH, Grotegerd D, Haarman B, Hahn T, Howells FM, Jamalabadi H, Jansen A, Kircher T, Klahn AL, Kuplicki R, Lahud E, Landén M, Leehr EJ, Lopez‐Jaramillo C, Mackey S, Malt U, Martyn F, Mazza E, McDonald C, McPhilemy G, Meier S, Meinert S, Melloni E, Mitchell PB, Nabulsi L, Nenadić I, Nitsch R, Opel N, Ophoff RA, Ortuño M, Overs BJ, Pineda‐Zapata J, Pomarol‐Clotet E, Radua J, Repple J, Roberts G, Rodriguez‐Cano E, Sacchet MD, Salvador R, Savitz J, Scheffler F, Schofield PR, Schürmeyer N, Shen C, Sim K, Sponheim SR, Stein DJ, Stein F, Straube B, Suo C, Temmingh H, Teutenberg L, Thomas‐Odenthal F, Thomopoulos SI, Urosevic S, Usemann P, van Haren NEM, Vargas C, Vieta E, Vilajosana E, Vreeker A, Winter NR, Yatham LN, Thompson PM, Andreassen OA, Ching CRK, Hajek T. Principal component analysis as an efficient method for capturing multivariate brain signatures of complex disorders-ENIGMA study in people with bipolar disorders and obesity. Hum Brain Mapp 2024; 45:e26682. [PMID: 38825977 PMCID: PMC11144951 DOI: 10.1002/hbm.26682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 06/04/2024] Open
Abstract
Multivariate techniques better fit the anatomy of complex neuropsychiatric disorders which are characterized not by alterations in a single region, but rather by variations across distributed brain networks. Here, we used principal component analysis (PCA) to identify patterns of covariance across brain regions and relate them to clinical and demographic variables in a large generalizable dataset of individuals with bipolar disorders and controls. We then compared performance of PCA and clustering on identical sample to identify which methodology was better in capturing links between brain and clinical measures. Using data from the ENIGMA-BD working group, we investigated T1-weighted structural MRI data from 2436 participants with BD and healthy controls, and applied PCA to cortical thickness and surface area measures. We then studied the association of principal components with clinical and demographic variables using mixed regression models. We compared the PCA model with our prior clustering analyses of the same data and also tested it in a replication sample of 327 participants with BD or schizophrenia and healthy controls. The first principal component, which indexed a greater cortical thickness across all 68 cortical regions, was negatively associated with BD, BMI, antipsychotic medications, and age and was positively associated with Li treatment. PCA demonstrated superior goodness of fit to clustering when predicting diagnosis and BMI. Moreover, applying the PCA model to the replication sample yielded significant differences in cortical thickness between healthy controls and individuals with BD or schizophrenia. Cortical thickness in the same widespread regional network as determined by PCA was negatively associated with different clinical and demographic variables, including diagnosis, age, BMI, and treatment with antipsychotic medications or lithium. PCA outperformed clustering and provided an easy-to-use and interpret method to study multivariate associations between brain structure and system-level variables. PRACTITIONER POINTS: In this study of 2770 Individuals, we confirmed that cortical thickness in widespread regional networks as determined by principal component analysis (PCA) was negatively associated with relevant clinical and demographic variables, including diagnosis, age, BMI, and treatment with antipsychotic medications or lithium. Significant associations of many different system-level variables with the same brain network suggest a lack of one-to-one mapping of individual clinical and demographic factors to specific patterns of brain changes. PCA outperformed clustering analysis in the same data set when predicting group or BMI, providing a superior method for studying multivariate associations between brain structure and system-level variables.
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Affiliation(s)
- Sean R. McWhinney
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Jaroslav Hlinka
- Department of Complex SystemsInstitute of Computer Science, Czech Academy of SciencesPragueCzech Republic
- National Institute of Mental HealthKlecanyCzech Republic
| | - Eduard Bakstein
- National Institute of Mental HealthKlecanyCzech Republic
- Department of CyberneticsCzech Technical UniversityPragueCzech Republic
| | - Lorielle M. F. Dietze
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
- Department of Medical NeuroscienceDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Christoph Abé
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Martin Alda
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
- National Institute of Mental HealthKlecanyCzech Republic
| | - Nina Alexander
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Francesco Benedetti
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
| | - Erlend Bøen
- Unit for Psychosomatics/CL Outpatient Clinic for Adults, Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Linda M. Bonnekoh
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
- Department of Child Adolescent Psychiatry and PsychotherapyUniversity of MünsterMünsterGermany
| | - Birgitte Boye
- Unit for Psychosomatics and C‐L Psychiatry for AdultsOslo University HospitalOsloNorway
- Department of Behavioural MedicineInstitute of Basic Medical Sciences, University of OsloOsloNorway
| | - Katharina Brosch
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
- Institute of Behavioral ScienceFeinstein Institutes for Medical ResearchManhassetNew YorkUSA
| | - Erick J. Canales‐Rodríguez
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAM, Instituto de Salud Carlos IIIBarcelonaSpain
| | - Dara M. Cannon
- Clinical Neuroimaging Laboratory, Galway Neuroscience CentreCollege of Medicine Nursing and Health Sciences, University of GalwayGalwayIreland
| | - Udo Dannlowski
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Caroline Demro
- Department of Psychiatry & Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Ana Diaz‐Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of MedicineUniversidad de AntioquiaMedellinColombia
| | - Torbjørn Elvsåshagen
- Department of Behavioural MedicineInstitute of Basic Medical Sciences, University of OsloOsloNorway
- Institute of Clinical Medicine, Norwegian Centre for Mental Disorders Research (NORMENT)University of Oslo and Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
- Department of Neurology, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
| | - Lisa T. Eyler
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
- Desert‐Pacific MIRECC, VA San Diego HealthcareSan DiegoCaliforniaUSA
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Janice M. Fullerton
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of Biomedical Sciences, Faculty of Medicine & HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Janik Goltermann
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Ian H. Gotlib
- Department of PsychologyStanford UniversityStanfordCaliforniaUSA
| | - Dominik Grotegerd
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Bartholomeus Haarman
- Department of PsychiatryUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Tim Hahn
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Fleur M. Howells
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Hamidreza Jamalabadi
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Andreas Jansen
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
- Core‐Facility Brainimaging, Faculty of MedicineUniversity of MarburgGermany
| | - Tilo Kircher
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Anna Luisa Klahn
- Institute of Neuroscience and PhysiologySahlgrenska Academy at Gothenburg UniversityGothenburgSweden
| | | | - Elijah Lahud
- Department of Psychiatry & Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Mikael Landén
- Institute of Neuroscience and PhysiologySahlgrenska Academy at Gothenburg UniversityGothenburgSweden
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Elisabeth J. Leehr
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Carlos Lopez‐Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of MedicineUniversidad de AntioquiaMedellinColombia
| | - Scott Mackey
- Department of PsychiatryUniversity of Vermont College of MedicineBurlingtonVermontUSA
| | - Ulrik Malt
- Unit for Psychosomatics/CL Outpatient Clinic for Adults, Division of Mental Health and AddictionOslo University HospitalOsloNorway
- Institute of Clinical Medicine, Department of NeurologyUniversity of OsloOsloNorway
| | - Fiona Martyn
- Clinical Neuroimaging Laboratory, Galway Neuroscience CentreCollege of Medicine Nursing and Health Sciences, University of GalwayGalwayIreland
| | - Elena Mazza
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Colm McDonald
- Clinical Neuroimaging Laboratory, Galway Neuroscience CentreCollege of Medicine Nursing and Health Sciences, University of GalwayGalwayIreland
| | - Genevieve McPhilemy
- Clinical Neuroimaging Laboratory, Galway Neuroscience CentreCollege of Medicine Nursing and Health Sciences, University of GalwayGalwayIreland
| | - Sandra Meier
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Susanne Meinert
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
- Institute for Translational NeuroscienceUniversity of MünsterMünsterGermany
| | - Elisa Melloni
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Philip B. Mitchell
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine & HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Leila Nabulsi
- Clinical Neuroimaging Laboratory, Galway Neuroscience CentreCollege of Medicine Nursing and Health Sciences, University of GalwayGalwayIreland
| | - Igor Nenadić
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Robert Nitsch
- Institute for Translational NeuroscienceUniversity of MünsterMünsterGermany
| | - Nils Opel
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
- Department of Psychiatry and PsychotherapyJena University HospitalJenaGermany
- German Center for Mental Health (DZPG), Site Jena‐Magdeburg‐HalleGermany
| | - Roel A. Ophoff
- UCLA Center for Neurobehavioral GeneticsLos AngelesCaliforniaUSA
| | - Maria Ortuño
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | | | - Julian Pineda‐Zapata
- Research GroupInstituto de Alta Tecnología Médica, Ayudas diagnósticas SURAMedellinColombia
| | - Edith Pomarol‐Clotet
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAM, Instituto de Salud Carlos IIIBarcelonaSpain
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Jonathan Repple
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyGoethe University Frankfurt, University HospitalFrankfurtGermany
| | - Gloria Roberts
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine & HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Elena Rodriguez‐Cano
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAM, Instituto de Salud Carlos IIIBarcelonaSpain
| | - Matthew D. Sacchet
- Meditation Research Program, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAM, Instituto de Salud Carlos IIIBarcelonaSpain
| | - Jonathan Savitz
- Laureate Institute for Brain ResearchTulsaOklahomaUSA
- Oxley College of Health SciencesThe University of TulsaTulsaOklahomaUSA
| | - Freda Scheffler
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Peter R. Schofield
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of Biomedical Sciences, Faculty of Medicine & HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Navid Schürmeyer
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Chen Shen
- Department of PsychologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kang Sim
- West Region, Institute of Mental HealthSingaporeSingapore
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Scott R. Sponheim
- Department of Psychiatry & Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA
- Minneapolis VA Health Care SystemMinneapolisMinnesotaUSA
| | - Dan J. Stein
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
- South African MRC Unit on Risk & Resilience in Mental DisordersUniversity of Cape TownCape TownSouth Africa
| | - Frederike Stein
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Benjamin Straube
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Chao Suo
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical ImagingMonash UniversityMelbourneVictoriaAustralia
| | - Henk Temmingh
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Lea Teutenberg
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | | | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Snezana Urosevic
- Department of Psychiatry & Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA
- Minneapolis VA Health Care SystemMinneapolisMinnesotaUSA
| | - Paula Usemann
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Neeltje E. M. van Haren
- Department of Child and Adolescent Psychiatry/PsychologyErasmus University Medical CenterRotterdamThe Netherlands
- Department of PsychiatryUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Cristian Vargas
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of MedicineUniversidad de AntioquiaMedellinColombia
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos III, Institute of NeuroscienceUniversity of Barcelona, Hospital ClínicBarcelonaSpain
| | - Enric Vilajosana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Annabel Vreeker
- Department of Child and Adolescent Psychiatry/PsychologyErasmus University Medical CenterRotterdamThe Netherlands
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
| | - Nils R. Winter
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | | | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Ole A. Andreassen
- Institute of Clinical Medicine, Norwegian Centre for Mental Disorders Research (NORMENT)University of Oslo and Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
| | - Christopher R. K. Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
- National Institute of Mental HealthKlecanyCzech Republic
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Zhang X, Han L, Lu C, McIntyre RS, Teopiz KM, Wang Y, Chen H, Cao B. Brain structural and functional alterations in individuals with combined overweight/obesity and mood disorders: A systematic review of neuroimaging studies. J Affect Disord 2023; 334:166-179. [PMID: 37149050 DOI: 10.1016/j.jad.2023.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
Growing evidence suggests there is a bidirectional relationship between depression and obesity, which are associated with structural and functional brain abnormalities. However, the underlying neurobiological mechanisms subserving the foregoing associations have yet to be characterized. It is necessary to summarize the neuroplastic brain changes in relation to depression and obesity. We systematically searched articles from 1990 to November 2022 on databases including MEDLINE/PubMed, Web of Science, PsycINFO. Only neuroimaging studies within the scope of potential differences in brain function and structure in individuals with depression and obesity/ BMI changes were included. Twenty-four eligible studies were included in the review herein, consisting of 17 studies reporting changes in brain structure, 4 studies reporting abnormal brain function, and 3 studies reporting both changes in brain structure and function. Results indicated an interaction between depression and obesity on brain functions, and their influence on brain structure is both extensive and specific. Overall, reduced whole brain, intracranial, and gray matter volume (e.g. frontal, temporal gyri, thalamic, and hippocampal) and impaired white matter integrity was observed in persons with depression and obesity comorbidity. Additional evidence on resting state fMRI reveals select brain regions associated with cognitive control, emotion regulation, and reward functions. Due to the diversity of tasks in task fMRI, the distinct neural activation patterns are revealed separately. The bidirectional relationship between depression and obesity reflects different characteristics in brain structure and function. Longitudinal designs should be reinforced in follow-up studies.
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Affiliation(s)
- Xinhe Zhang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China
| | - Lin Han
- The First Affiliated Hospital of Xi'an Medical University, Xi'an, PR China
| | - Chenxuan Lu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Roger S McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada; Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Yiyi Wang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
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3
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McWhinney SR, Abé C, Alda M, Benedetti F, Bøen E, del Mar Bonnin C, Borgers T, Brosch K, Canales-Rodríguez EJ, Cannon DM, Dannlowski U, Diaz-Zuluaga AM, Dietze LM, Elvsåshagen T, Eyler LT, Fullerton JM, Goikolea JM, Goltermann J, Grotegerd D, Haarman BCM, Hahn T, Howells FM, Ingvar M, Jahanshad N, Kircher TTJ, Krug A, Kuplicki RT, Landén M, Lemke H, Liberg B, Lopez-Jaramillo C, Malt UF, Martyn FM, Mazza E, McDonald C, McPhilemy G, Meier S, Meinert S, Meller T, Melloni EMT, Mitchell PB, Nabulsi L, Nenadic I, Opel N, Ophoff RA, Overs BJ, Pfarr JK, Pineda-Zapata JA, Pomarol-Clotet E, Raduà J, Repple J, Richter M, Ringwald KG, Roberts G, Ross A, Salvador R, Savitz J, Schmitt S, Schofield PR, Sim K, Stein DJ, Stein F, Temmingh HS, Thiel K, Thomopoulos SI, van Haren NEM, Vargas C, Vieta E, Vreeker A, Waltemate L, Yatham LN, Ching CRK, Andreassen OA, Thompson PM, Hajek T. Mega-analysis of association between obesity and cortical morphology in bipolar disorders: ENIGMA study in 2832 participants. Psychol Med 2023; 53:1-11. [PMID: 36846964 PMCID: PMC10600817 DOI: 10.1017/s0033291723000223] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/05/2023] [Accepted: 01/19/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact. METHODS We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations. RESULTS BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI. CONCLUSIONS We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.
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Affiliation(s)
| | - Christoph Abé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, Psychiatry and Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Erlend Bøen
- Unit for Psychosomatics/CL Outpatient Clinic for Adults, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Caterina del Mar Bonnin
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Tiana Borgers
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | | | - Dara M. Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ana M. Diaz-Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | | | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lisa T. Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Desert-Pacific MIRECC, VA San Diego Healthcare, San Diego, CA, USA
| | - Janice M. Fullerton
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Jose M. Goikolea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Janik Goltermann
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Bartholomeus C. M. Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tim Hahn
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Fleur M. Howells
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Tilo T. J. Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | | | - Mikael Landén
- Department of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hannah Lemke
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Benny Liberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Carlos Lopez-Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Ulrik F. Malt
- Unit for Psychosomatics/CL Outpatient Clinic for Adults, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fiona M. Martyn
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Elena Mazza
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, Psychiatry and Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Genevieve McPhilemy
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Susanne Meinert
- Department of Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Elisa M. T. Melloni
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, Psychiatry and Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Philip B. Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Leila Nabulsi
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Roel A. Ophoff
- UCLA Center for Neurobehavioral Genetics, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Julian A. Pineda-Zapata
- Research Group, Instituto de Alta Tecnología Médica, Ayudas diagnósticas SURA, Medellin, Colombia
| | | | - Joaquim Raduà
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institute of Psychiartry, King's College Londen, London, UK
| | - Jonathan Repple
- Department of Psychiatry, University of Münster, Münster, Germany
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Maike Richter
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Kai G. Ringwald
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Alex Ross
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Jonathan Savitz
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Peter R. Schofield
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dan J. Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Henk S. Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Katharina Thiel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Neeltje E. M. van Haren
- Department of Child and Adolescents Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cristian Vargas
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Annabel Vreeker
- Department of Child and Adolescents Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Erasmus School of Social and Behavioural Sciences Department of Psychology, Education & Child Studies Erasmus University, Rotterdam, The Netherlands
| | - Lena Waltemate
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Christopher R. K. Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- National Institute of Mental Health, Klecany, Czech Republic
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