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Increased body mass index makes an impact on brain white-matter integrity in adults with remitted first-episode mania

Published online by Cambridge University Press:  26 April 2013

C. N. Kuswanto ,
M. Y. Sum ,
G. L. Yang ,
W. L. Nowinski ,
R. S. McIntyre  and
K. Sim
C. N. Kuswanto
Affiliation:
Research Department, Institute of Mental Health, Singapore
M. Y. Sum
Affiliation:
Research Department, Institute of Mental Health, Singapore
G. L. Yang
Affiliation:
Biomedical Imaging Laboratory, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
W. L. Nowinski
Affiliation:
Biomedical Imaging Laboratory, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
R. S. McIntyre
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada
K. Sim*
Affiliation:
Research Department, Institute of Mental Health, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore
*
*Address for correspondence: K. Sim, Department of General Psychiatry, Institute of Mental Health/Woodbridge Hospital, 10, Buangkok View, Singapore539747. (Email: kang_sim@imh.com.sg)
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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 F1,48 = 5.02, p = 0.030), occipital lobe (adjusted F1,48 = 10.30, p = 0.002) and temporal lobe (adjusted F1,48 = 7.92, p = 0.007). Specifically, decreased FA is found in the right parietal (F1,23 = 5.864, p = 0.023) and occipital lobes (F1,23 = 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 (F1,25 = 6.708, p = 0.015), temporal (F1,25 = 10.751, p = 0.003) and occipital (F1,25 = 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.

Keywords

Bipolar disorderbody mass indexdiffusion tensor imagingfirst-episode maniafractional anisotropyobesity
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 3 , February 2014 , pp. 533 - 541
Copyright
Copyright © Cambridge University Press 2013 

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