White matter microstructure and cognitive decline in metabolic syndrome: a review of diffusion tensor imaging

Alfaro, Freddy J.; Gavrieli, Anna; Saade-Lemus, Patricia; Lioutas, Vasileios‐Arsenios; Upadhyay, Jagriti; Novak, Vera

doi:10.1016/j.metabol.2017.08.009

Cited by 101 publications

(86 citation statements)

References 210 publications

(224 reference statements)

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“…These results are consistent with previous studies showing that insulin resistance negatively affects brain function and structure within the hippocampus, dorsolateral prefrontal cortex as well as medial and temporal regions, which may contribute to cognitive impairment (49,50). There is also some evidence linking dyslipidemia and abnormal lipid metabolism with global and regional GM or WM atrophy or WM hyperintensities (13). Even if the specific contribution of each metabolic change cannot be established in the present study, our results suggest that improvements of glucose homeostasis and dyslipidemia following weight-loss might reverse the obesity-related WM and GM volume alterations.…”

Section: Discussionsupporting

confidence: 92%

“…Imaging studies in humans previously reported that obese individuals have reduced WM tissue density and altered WM integrity in dispersed tracts, including the corpus callosum, cingulum, cerebellar peduncle and corona radiata (9,12,13,17,19,29,43). These findings align well with our cross-sectional results showing that WM density in brain stem and cerebellar peduncle, two regions that significantly increased after SG, were reduced in severely obese individuals compared to normal-weight individuals.…”

Section: Discussionsupporting

confidence: 91%

“…Findings on WM structure and integrity in obesity are less clear (12,13). Some studies report a positive association between obesity and WM density in frontal, temporal and parietal regions (6,14), while other studies find a negative association in basal ganglia and corona radiata (15).…”

Section: Introductionmentioning

confidence: 99%

“…Some studies report a positive association between obesity and WM density in frontal, temporal and parietal regions (6,14), while other studies find a negative association in basal ganglia and corona radiata (15). WM hyperintensities, which are markers of central nervous system ischemic disease, have also been observed in greater numbers in obese individuals (12,13,16). Studies using diffusion tensor imaging have shown a loss of WM integrity linked to cognitive impairments in obese participants (7,(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

“…Animal studies suggest that chronic inflammation associated with obesity can lead to adverse effects on brain tissue (20,21). Intriguingly, recent discoveries in humans point to the chronic low-grade inflammation as a potential mechanism to explain obesity-induced WM alterations (13,16,19,21,22). However, it is unclear if these brain changes are permanent or whether they can be reversed after weight loss.…”

Section: Introductionmentioning

confidence: 99%

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Neuroanatomical Changes in White and Grey Matter after Sleeve Gastrectomy

Michaud

Dadar

Pelletier

et al. 2019

Preprint

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Background: MRI studies show that obese adults have reduced grey (GM) and white matter (WM) tissue density as well as altered WM integrity. It remains to be examined if bariatric surgery induces structural brain changes. The aim of this study is to characterize GM and WM density changes in a longitudinal setting, comparing pre-and post-operation and to determine whether these changes are related to inflammation and cardiometabolic markers. Methods: 29 severely obese participants (age: 45.9±7.8 years) scheduled to undergo sleeve gastrectomy (SG) were recruited. High-resolution T1-weighted anatomical images were acquired 1 month prior to as well as 4 and 12 months after surgery. GM and WM densities were quantified using voxel-based morphometry (VBM). Circulating lipid profile, glucose, insulin and inflammatory markers (interleukin (IL)-6, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) were measured at each time point.A linear mixed effect model was used to compare brain changes before and after SG, controlling for age, gender, initial BMI and diabetic status. To assess the associations between changes in adiposity, metabolism and inflammation and changes in GM or WM density, the mean GM and WM densities were extracted across all the participants using atlas, and linear mixed-effect models were used. Results: As expected, weight, BMI, waist circumference and neck circumference significantly decreased after SG compared with baseline (p<0.001 for all). A widespread increase in WM density was observed after surgery, particularly in the cerebellum, brain stem, cerebellar peduncle, cingulum, corpus callosum and corona radiata (p<0.05, after FDR correction). Significant increases in GM density were observed 4 months after SG compared to baseline in several brain regions such as the bilateral occipital cortex, temporal cortex, precentral gyrus and cerebellum as Michaud et al. 2019, page 3 well as right fusiform gyrus, right hippocampus and right insula. These GM and WM increases were more pronounced and widespread after 12 months and were significantly associated with post-operative weight loss and the improvement of metabolic alterations.Our linear mixed-effect models also showed strong associations between post-operative reductions in LBP, a marker of inflammation, and increased WM density. To confirm our results, we tested whether the peak of each significant region showed BMI-related differences in an independent dataset (Human Connectome Project). We matched a group of severely obese individuals with a group of lean individuals for age, gender and ethnicity.Severe obesity was associated with reduced WM density in the brain stem and cerebellar peduncle as well as reduced GM density in cerebellum, regions that significantly changed after surgery (p<0.01 for all clusters). Conclusions: Bariatric surgery-induced weight loss and improvement in metabolic alterations is associated with widespread increases in WM and GM densities. These post-operative changes overlapped with baseline brain difference...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Neuroanatomical Changes in White and Grey Matter after Sleeve Gastrectomy

Michaud

Dadar

Pelletier

et al. 2019

Preprint

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Neurobiology and Neurophysiology of Behavioral/Psychiatric Disorders

Boorin¹,

Keltner²

2021

Child and Adolescent Behavioral Health

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Brain white matter microstructure in obese women with binge eating disorder

Estella

Sanches

Maranhão

et al. 2020

Euro Eating Disorders Rev

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Objective Research on potential brain circuit abnormalities in binge eating disorder (BED) is limited. Here, we assess white matter (WM) microstructure in obese women with BED. Method Diffusion tensor imaging data were acquired, and tract‐based spatial statistics used to examine WM in women with BED who were obese (n = 17) compared to normal‐weight (NWC) (n = 17) and to women who were obese (OBC) (n = 13). Body mass index (BMI) was a covariate in the analyses. Results The BED group (vs. NWC) had greater axial diffusion (AD) in the forceps minor, anterior thalamic radiation, superior and inferior longitudinal fasciculus, that is, in pathways connecting fronto‐limbic regions. Microstructures differences in AD between the BED and OBC groups were seen in fronto‐limbic pathways extending to temporoparietal pathways. The BED (vs. OBC) group had greater fractional anisotropy in the forceps minor and greater AD in the superior longitudinal fasciculus, cingulate gyrus, and corpus callosum, consistent with fronto‐tempoparietal pathways. Conclusion Women with BED show WM alterations in AD in fronto‐limbic and parietal pathways that are important in decision‐making processes. As BMI was a covariate in the analyses, alterations in BED may be part of the pathology, but whether they are a cause or effect of illness is unclear.

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White matter microstructure and cognitive decline in metabolic syndrome: a review of diffusion tensor imaging

Cited by 101 publications

References 210 publications

Neuroanatomical Changes in White and Grey Matter after Sleeve Gastrectomy

Neuroanatomical Changes in White and Grey Matter after Sleeve Gastrectomy

Neurobiology and Neurophysiology of Behavioral/Psychiatric Disorders

Brain white matter microstructure in obese women with binge eating disorder

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