Dietze Lorielle M F, McWhinney Sean R, Favre Pauline, Abé Christoph, Alexander Nina, Barkhau Carlotta, Benedetti Francesco, Berk Michael, Bøen Erlend, Boye Birgitte, Brosch Katharina, Canales-Rodríguez Erick J, Cannon Dara M, Carruthers Sean P, Corkum Emily L V, Dannlowski Udo, Díaz-Zuluaga Ana M, Dohm Katharina, Elvsåshagen Torbjørn, Flinkenflügel Kira, Fortea Lydia, Furlong Lisa S, Goldstein Benjamin I, Grotegerd Dominik, Gruber Marius, Haarman Bartholomeus C M, Howells Fleur M, Jahanshad Neda, Jamalabadi Hamidreza, Jansen Andreas, Karantonis James A, Kennedy Kody G, Kircher Tilo T J, Klahn Anna Luisa, Kochunov Peter, Kraus Anna, Landén Mikael, López-Jaramillo Carlos, MacIntosh Bradley J, Mazza Elena, McDonald Colm, McIntosh Andrew M, Meinert Hannah, Meinert Susanne, Melloni Elisa M T, Mitchell Philip B, Nenadić Igor, Opel Nils, Phillips Mary, Piguet Camille, Polosan Mircea, Pomarol-Clotet Edith, Pouchon Arnaud, Radua Joaquim, Roberts Gloria, Ross Alex J, Rossell Susan L, Salvador Raymond, Sim Kang, Soares Jair C, Zunta-Soares Giovana B, Stein Frederike, Straube Benjamin, Suo Chao, Teutenberg Lea, Thomas-Odenthal Florian, Thomopoulos Sophia I, Usemann Paula, Van Rheenen Tamsyn E, Versace Amelia, Vieta Eduard, Vilajosana Enric, Mwangi Benson, Wen Wei, Whalley Heather C, Wu Mon-Ju, Andreassen Ole A, Ching Christopher R K, Thompson Paul M, Houenou Josselin, Hajek Tomas
Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada.
Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Mol Psychiatry. 2025 May;30(5):1770-1779. doi: 10.1038/s41380-024-02784-2. Epub 2024 Nov 5.
Although specific risk factors for brain alterations in bipolar disorders (BD) are currently unknown, obesity impacts the brain and is highly prevalent in BD. Gray matter correlates of obesity in BD have been well documented, but we know much less about brain white matter abnormalities in people who have both obesity and BD. We obtained body mass index (BMI) and diffusion tensor imaging derived fractional anisotropy (FA) from 22 white matter tracts in 899 individuals with BD, and 1287 control individuals from 20 cohorts in the ENIGMA-BD working group. In a mega-analysis, we investigated the associations between BMI, diagnosis or medication and FA. Lower FA was associated with both BD and BMI in six white matter tracts, including the corpus callosum and thalamic radiation. Higher BMI or BD were uniquely associated with lower FA in three and six white matter tracts, respectively. People not receiving lithium treatment had a greater negative association between FA and BMI than people treated with lithium in the posterior thalamic radiation and sagittal stratum. In three tracts BMI accounted for 10.5 to 17% of the negative association between the number of medication classes other than lithium and FA. Both overweight/obesity and BD demonstrated lower FA in some of the same regions. People prescribed lithium had a weaker association between BMI and FA than people not on lithium. In contrast, greater weight contributed to the negative associations between medications and FA. Obesity may add to brain alterations in BD and may play a role in effects of medications on the brain.
尽管目前尚不清楚双相情感障碍（BD）患者大脑改变的具体风险因素，但肥胖会影响大脑，且在BD患者中极为普遍。BD患者中肥胖与灰质的相关性已有充分记录，但对于同时患有肥胖症和BD的人的脑白质异常，我们了解得要少得多。我们从ENIGMA-BD工作组的20个队列中的899名BD患者和1287名对照个体中获取了体重指数（BMI）以及通过扩散张量成像得出的22条白质束的各向异性分数（FA）。在一项大型分析中，我们研究了BMI、诊断或药物治疗与FA之间的关联。在包括胼胝体和丘脑辐射在内的6条白质束中，较低的FA与BD和BMI均相关。较高的BMI或BD分别在3条和6条白质束中与较低的FA有独特关联。在丘脑后辐射和矢状层中，未接受锂治疗的人FA与BMI之间的负相关性比接受锂治疗的人更强。在3条白质束中，BMI占锂以外药物种类数量与FA之间负相关性的10.5%至17%。超重/肥胖和BD在某些相同区域均表现出较低的FA。服用锂的人BMI与FA之间的关联比未服用锂的人弱。相反，体重增加导致药物与FA之间产生负相关。肥胖可能会加重BD患者的大脑改变，并可能在药物对大脑的作用中发挥作用。
