Hippocampus size does not correlate with body mass index in bipolar disorder

Viana-Sulzbach, Miréia; Pedrini, Mariana; Bücker, Joana; Brietzke, Elisa; Gama, Clarissa Severino

doi:10.1590/1516-4446-2015-1816

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…The relationship between CSWG and decreasing hippocampal NAA was independent of hippocampal volume changes, which were not related to CSWG. The lack of association between weight and hippocampal volumes in BD, which was also previously reported in a small cross-sectional study (Viana-Sulzbach, Pedrini, Bücker, Brietzke, & Gama, 2016), has implications for understanding the relationships between weight gain and neuroprogression in BD. First, it suggests that CSWG predicts primary changes in hippocampal NAA rather than changes that are secondary to hippocampal structural abnormalities.…”

Section: Discussionsupporting

confidence: 54%

Weight gain as a risk factor for progressive neurochemical abnormalities in first episode mania patients: a longitudinal magnetic resonance spectroscopy study

et al. 2021

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Background We previously reported that bipolar disorder (BD) patients with clinically significant weight gain (CSWG; ⩾7% of baseline weight) in the 12 months after their first manic episode experienced greater limbic brain volume loss than patients without CSWG. It is unknown whether CSWG is also a risk factor for progressive neurochemical abnormalities. Methods We investigated whether 12-month CSWG predicted greater 12-month decreases in hippocampal N-acetylaspartate (NAA) and greater increases in glutamate + glutamine (Glx) following a first manic episode. In BD patients (n = 58) and healthy comparator subjects (HS; n = 34), we measured baseline and 12-month hippocampal NAA and Glx using bilateral 3-Tesla single-voxel proton magnetic resonance spectroscopy. We used general linear models for repeated measures to investigate whether CSWG predicted neurochemical changes. Results Thirty-three percent of patients and 18% of HS experienced CSWG. After correcting for multiple comparisons, CSWG in patients predicted a greater decrease in left hippocampal NAA (effect size = −0.52, p = 0.005). CSWG also predicted a greater decrease in left hippocampal NAA in HS with a similar effect size (−0.53). A model including patients and HS found an effect of CSWG on Δleft NAA (p = 0.007), but no diagnosis effect and no diagnosis × CSWG interaction, confirming that CSWG had similar effects in patients and HS. Conclusion CSWG is a risk factor for decreasing hippocampal NAA in BD patients and HS. These results suggest that the well-known finding of reduced NAA in BD may result from higher body mass index in patients rather than BD diagnosis.

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Section: Discussionsupporting

confidence: 54%

Weight gain as a risk factor for progressive neurochemical abnormalities in first episode mania patients: a longitudinal magnetic resonance spectroscopy study

et al. 2021

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“…The findings of Stop-EM study found a more severe neurochemical impairment in the hippocampus of obese/overweight compared normal weight patients (Bond et al ., 2016, 2017 a , 2017 b ) but no similar finding was evident for volumes of cortical regions (Bond et al ., 2011). Six other brain imaging studies investigated BMI as a dimensional variable (Bond et al ., 2011, 2014, 2015; Viana-Sulzbach et al ., 2016; Islam et al ., 2017; Mazza et al ., 2017). Increased BMI was related to disrupted microstructure (Mazza et al ., 2017) and volume (Bond et al ., 2011, 2014) of white matter, reduced gray matter volume in temporal lobe (Bond et al ., 2011, 2014), reduced cortical thickness in frontal lobe (Islam et al ., 2017), and neurochemical abnormality (Bond et al ., 2016) but not related to reduced hippocampal volume (Viana-Sulzbach et al ., 2016).…”

Section: Resultsmentioning

confidence: 99%

Neurococognitive and neuroimaging correlates of obesity and components of metabolic syndrome in bipolar disorder: a systematic review

2018

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BackgroundIndividuals with bipolar disorder (BD) have a higher prevalence of obesity and metabolic syndrome (MetS) compared with the general population. Obesity and MetS are associated with cognitive deficits and brain imaging abnormalities in the general population. Obesity and components of MetS might potentially associate with neuroimaging and neurocognitive findings in BD.MethodsA literature search of studies investigating the association between obesity (and other components of MetS) and neurocognitive and neuroimaging findings in BD was conducted. In addition to a systematic review, a random-effects meta-analysis was conducted when sufficient data were available.ResultsTwenty-three studies were included in the current systematic review. Overweight/obese patients were significantly associated with impaired neurocognition compared normal weight individuals with BD (d = 0.37). The most robust association between obesity and cognitive deficits in BD was observed in the cognitive subdomain of executive functions (d = 0.61). There was also evidence for a significant relationship between cognitive impairment in BD and other components of MetS including hypertension, dyslipidemia, and diabetes. Overweight/obese individuals with BD had more pronounced brain imaging abnormalities than normal weight individuals with BD.ConclusionsObesity and related cardiovascular risk factors significantly are associated with more severe cognitive and brain imaging abnormalities in BD. Medical co-morbidities can potentially contribute to functional decline observed in some patients throughout the course of BD.

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“…In one first‐episode mania sample, higher BMI predicted greater hippocampal glutamate and lower hippocampal N‐acetylaspartate (NAA) in bipolar disorder patients 185,186 . ) Interestingly, this was independent of any effect of BMI on hippocampal volumes, since two separate groups reported that hippocampal volume did not vary with BMI in bipolar disorder patients 186,187 . That BMI‐related brain changes were located primarily in limbic brain areas, and that they were detected in bipolar disorder patients but not age‐ and gender‐matched control subjects, suggests that higher BMI is associated with unique brain changes in bipolar disorder, such that frontal/temporal limbic brain changes characteristic of bipolar disorder are more pronounced with higher BMI.…”

Section: Vascular‐related Neuroimagingmentioning

confidence: 99%

Call to action regarding the vascular‐bipolar link: A report from the Vascular Task Force of the International Society for Bipolar Disorders

et al. 2020

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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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Hippocampus size does not correlate with body mass index in bipolar disorder

Cited by 4 publications

References 5 publications

Weight gain as a risk factor for progressive neurochemical abnormalities in first episode mania patients: a longitudinal magnetic resonance spectroscopy study

Weight gain as a risk factor for progressive neurochemical abnormalities in first episode mania patients: a longitudinal magnetic resonance spectroscopy study

Neurococognitive and neuroimaging correlates of obesity and components of metabolic syndrome in bipolar disorder: a systematic review

Call to action regarding the vascular‐bipolar link: A report from the Vascular Task Force of the International Society for Bipolar Disorders

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