Targeting obesity could slow brain aging in psychosis

 

Being overweight or obese could be a risk factor for the kind of brain aging seen in some patients with first-episode psychosis (FEP), new research suggests.

The investigators found significant associations between BrainAGE scores and a diagnosis of FEP (P = .005), overweight/obesity category (P = .007), and body mass index (P = .02). Furthermore, the association found between BrainAGE score and BMI was related to an association between BrainAGE score and weight (P = .009), but not to height (P = .13).

“These findings raise the possibility that targeting metabolic health in FEP and intervening already at the level of overweight/obesity could slow brain aging in schizophrenia and related disorders,” reported Marian Kolenic of the National Institute of Mental Health in Klecany, Czech Republic, and his coauthors.

The researchers recruited 120 patients with FEP as defined by the ICD-10 during their first psychiatric hospitalization. People with psychotic mood disorders were excluded.

“We wanted to recruit participants at the early stages of illness, to minimize the effects of illness and medications on brain structure,” the investigators wrote.

One hundred fourteen healthy controls were recruited through advertisements, and exclusion criteria included a lifetime history of any psychiatric disorders and the presence of psychotic disorders in either first- or second-degree relatives.

All participants were asked about their medical history, including their use and/or abuse of substances. Fasting blood samples were collected on the scanning day.

 

A psychiatrist used the Mini-International Neuropsychiatric Interview and the Positive and Negative Syndrome Scale to determine diagnostic assessments and symptom ratings. Several CV risk factors were measured, including blood pressure, triglycerides, HDL, and LDL. Using the charts, the researchers verified the absence of diabetes by fasting glucose. They also checked participants’ BMI and height.

©Jochen Sand/Thinkstock

Through the use of MRI, participants’ brains were scanned, and their brain age was estimated via the BrainAGE score. This is calculated as the difference between estimated brain age and chronological age (Neuroimage. 2010. 50[3]:883-92).

“This study suggests that overweight/obesity, which is frequent in schizophrenia, may contribute to neurostructural changes already early in the course of illness,” the investigators wrote. “Specifically, the brains of participants with FEP appeared on average 2.64 years older than their chronological age.”

Among participants with both FEP and overweight/obesity, the investigators found the average discrepancy between brain and chronological age to be as high as 3.83 years.

They cited several limitations. Because the study was not prospective, the researchers could not establish causality of the association between metabolic alterations and brain structure. In addition, the existence of insulin resistance could not be ruled out – although none of the participants reported a history of type 2 diabetes.

Still, “the results were robust, persisted in subgroup analyses, and replicated many of the previously reported findings,” the investigators wrote.

They reported no conflicts of interest.

ghenderson@mdedge.com

SOURCE: Kolenic M et al. J Psychiatric Res. 2018 Apr. 99:151-8.

 

Being overweight or obese could be a risk factor for the kind of brain aging seen in some patients with first-episode psychosis (FEP), new research suggests.

The investigators found significant associations between BrainAGE scores and a diagnosis of FEP (P = .005), overweight/obesity category (P = .007), and body mass index (P = .02). Furthermore, the association found between BrainAGE score and BMI was related to an association between BrainAGE score and weight (P = .009), but not to height (P = .13).

“These findings raise the possibility that targeting metabolic health in FEP and intervening already at the level of overweight/obesity could slow brain aging in schizophrenia and related disorders,” reported Marian Kolenic of the National Institute of Mental Health in Klecany, Czech Republic, and his coauthors.

The researchers recruited 120 patients with FEP as defined by the ICD-10 during their first psychiatric hospitalization. People with psychotic mood disorders were excluded.

“We wanted to recruit participants at the early stages of illness, to minimize the effects of illness and medications on brain structure,” the investigators wrote.

One hundred fourteen healthy controls were recruited through advertisements, and exclusion criteria included a lifetime history of any psychiatric disorders and the presence of psychotic disorders in either first- or second-degree relatives.

All participants were asked about their medical history, including their use and/or abuse of substances. Fasting blood samples were collected on the scanning day.

 

A psychiatrist used the Mini-International Neuropsychiatric Interview and the Positive and Negative Syndrome Scale to determine diagnostic assessments and symptom ratings. Several CV risk factors were measured, including blood pressure, triglycerides, HDL, and LDL. Using the charts, the researchers verified the absence of diabetes by fasting glucose. They also checked participants’ BMI and height.

©Jochen Sand/Thinkstock

Through the use of MRI, participants’ brains were scanned, and their brain age was estimated via the BrainAGE score. This is calculated as the difference between estimated brain age and chronological age (Neuroimage. 2010. 50[3]:883-92).

“This study suggests that overweight/obesity, which is frequent in schizophrenia, may contribute to neurostructural changes already early in the course of illness,” the investigators wrote. “Specifically, the brains of participants with FEP appeared on average 2.64 years older than their chronological age.”

Among participants with both FEP and overweight/obesity, the investigators found the average discrepancy between brain and chronological age to be as high as 3.83 years.

They cited several limitations. Because the study was not prospective, the researchers could not establish causality of the association between metabolic alterations and brain structure. In addition, the existence of insulin resistance could not be ruled out – although none of the participants reported a history of type 2 diabetes.

Still, “the results were robust, persisted in subgroup analyses, and replicated many of the previously reported findings,” the investigators wrote.

They reported no conflicts of interest.

ghenderson@mdedge.com

SOURCE: Kolenic M et al. J Psychiatric Res. 2018 Apr. 99:151-8.

 

Being overweight or obese could be a risk factor for the kind of brain aging seen in some patients with first-episode psychosis (FEP), new research suggests.

The investigators found significant associations between BrainAGE scores and a diagnosis of FEP (P = .005), overweight/obesity category (P = .007), and body mass index (P = .02). Furthermore, the association found between BrainAGE score and BMI was related to an association between BrainAGE score and weight (P = .009), but not to height (P = .13).

“These findings raise the possibility that targeting metabolic health in FEP and intervening already at the level of overweight/obesity could slow brain aging in schizophrenia and related disorders,” reported Marian Kolenic of the National Institute of Mental Health in Klecany, Czech Republic, and his coauthors.

The researchers recruited 120 patients with FEP as defined by the ICD-10 during their first psychiatric hospitalization. People with psychotic mood disorders were excluded.

“We wanted to recruit participants at the early stages of illness, to minimize the effects of illness and medications on brain structure,” the investigators wrote.

One hundred fourteen healthy controls were recruited through advertisements, and exclusion criteria included a lifetime history of any psychiatric disorders and the presence of psychotic disorders in either first- or second-degree relatives.

All participants were asked about their medical history, including their use and/or abuse of substances. Fasting blood samples were collected on the scanning day.

 

A psychiatrist used the Mini-International Neuropsychiatric Interview and the Positive and Negative Syndrome Scale to determine diagnostic assessments and symptom ratings. Several CV risk factors were measured, including blood pressure, triglycerides, HDL, and LDL. Using the charts, the researchers verified the absence of diabetes by fasting glucose. They also checked participants’ BMI and height.

©Jochen Sand/Thinkstock

Through the use of MRI, participants’ brains were scanned, and their brain age was estimated via the BrainAGE score. This is calculated as the difference between estimated brain age and chronological age (Neuroimage. 2010. 50[3]:883-92).

“This study suggests that overweight/obesity, which is frequent in schizophrenia, may contribute to neurostructural changes already early in the course of illness,” the investigators wrote. “Specifically, the brains of participants with FEP appeared on average 2.64 years older than their chronological age.”

Among participants with both FEP and overweight/obesity, the investigators found the average discrepancy between brain and chronological age to be as high as 3.83 years.

They cited several limitations. Because the study was not prospective, the researchers could not establish causality of the association between metabolic alterations and brain structure. In addition, the existence of insulin resistance could not be ruled out – although none of the participants reported a history of type 2 diabetes.

Still, “the results were robust, persisted in subgroup analyses, and replicated many of the previously reported findings,” the investigators wrote.

They reported no conflicts of interest.

ghenderson@mdedge.com

SOURCE: Kolenic M et al. J Psychiatric Res. 2018 Apr. 99:151-8.