Obesity and brain structure in schizophrenia - ENIGMA study in 3021 individuals

• Type of Material: Article
• Authors: Sean R McWhinney, Dalhousie University; Katharina Brosch, Philipps University Marburg; Vince Calhoun, Emory University; Benedicto Crespo-Facorro, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Nicolas A Crossley, Pontificia Univ Catolica Chile; Udo Dannlowski, University of Munster; Erin Dickie, University of Toronto; Lorielle MF Dietze, Dalhousie University; Gary Donohoe, Natl Univ Ireland Galway; Stefan Du Plessis, Stellenbosch University; Stefan Ehrlich, Technische Universitat Dresden; Robin Emsley, Stellenbosch University; Petra Furstova, National Institute of Mental Health; David C Glahn, Boston Childrens Hospital; Alfonso Gonzalez-Valderrama, Universidad Finis Terrae; Dominik Grotegerd, University of Munster; Laurena Holleran, National University of Ireland Galway; Tilo TJ Kircher, Philipps University Marburg; Pavel Knytl, National Institute of Mental Health; Marian Kolenic, National Institute of Mental Health; Rebekka Lencer, University of Munster; Igor Nenadic, Philipps University Marburg; Nils Opel, University of Munster; Julia-Katharina Pfarr, Philipps University Marburg; Amanda L Rodrigue, Boston Childrens Hospital; Kelly Rootes-Murdy, Georgia State University; Alex J Ross, Dalhousie University; Kang Sim, Institute of Mental Health, Singapore; Antonín Škoch, National Institute of Mental Health, Klecany, Czech Republi; Filip Spaniel, National Institute of Mental Health, Klecany, Czech Republi; Frederike Stein, Philipps University Marburg; Patrik Švancer, Natl Inst Mental Hlth; Diana Tordesillas-Gutierrez, Marqués de Valdecilla University Hospital; Juan Undurraga, Inst Psiquiatr Dr Jose Horwitz B; Javier Vázquez-Bourgon, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Aristotle Voineskos, University of Toronto; Esther Walton, University of Bath; Thomas W Weickert, SUNY Upstate Medical University; Cynthia S Weickert, SUNY Upstate Medical University; Paul M Thompson, University of Southern California; Theo GM van Erp, University of California Irvine; Jessica A Turner, Georgia State University; Tomas Hajek, Dalhousie University
• Language: English
• Date: 2022-06-14
• Publisher: SPRINGERNATURE
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022, corrected publication 2023; © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41380-022-01616-5; https://doi.org/10.1038/s41380-023-02055-6
• Title of Journal or Parent Work: MOLECULAR PSYCHIATRY
• Volume: 27
• Issue: 9
• Start Page: 3731
• End Page: 3737
• Keywords: Psychiatry; Biochemistry & Molecular Biology; RISK; METABOLIC SYNDROME; 1ST-EPISODE; Neurosciences; DIABETES-MELLITUS; Science & Technology; GRAY-MATTER VOLUME; ABNORMALITIES; Neurosciences & Neurology; BODY-MASS INDEX; RESPONSIVENESS; Life Sciences & Biomedicine; MAJOR DEPRESSIVE DISORDER; MORTALITY

Abstract

Schizophrenia is frequently associated with obesity, which is linked with neurostructural alterations. Yet, we do not understand how the brain correlates of obesity map onto the brain changes in schizophrenia. We obtained MRI-derived brain cortical and subcortical measures and body mass index (BMI) from 1260 individuals with schizophrenia and 1761 controls from 12 independent research sites within the ENIGMA-Schizophrenia Working Group. We jointly modeled the statistical effects of schizophrenia and BMI using mixed effects. BMI was additively associated with structure of many of the same brain regions as schizophrenia, but the cortical and subcortical alterations in schizophrenia were more widespread and pronounced. Both BMI and schizophrenia were primarily associated with changes in cortical thickness, with fewer correlates in surface area. While, BMI was negatively associated with cortical thickness, the significant associations between BMI and surface area or subcortical volumes were positive. Lastly, the brain correlates of obesity were replicated among large studies and closely resembled neurostructural changes in major depressive disorders. We confirmed widespread associations between BMI and brain structure in individuals with schizophrenia. People with both obesity and schizophrenia showed more pronounced brain alterations than people with only one of these conditions. Obesity appears to be a relevant factor which could account for heterogeneity of brain imaging findings and for differences in brain imaging outcomes among people with schizophrenia.