Background
Compared with normal-weight patients, obese patients with bipolar I disorder (BD)
suffer more manic and depressive episodes and make more suicide attempts. In the general
population, obesity is associated with reduced total brain volume (TBV) and gray matter
volume (GMV), but the neurobiology of obesity in BD has not been investigated.
Methods
We used magnetic resonance imaging to examine TBV, GMV, white matter volume (WMV),
as well as frontal, parietal, occipital, and temporal lobe volumes, in 55 healthy
subjects (17 overweight/obese and 38 normal weight) and 57 patients with BD following
their first manic episode (20 overweight/obese and 37 normal weight).
Results
Linear regression analyses demonstrated that when other predictors of brain volume
were accounted for, increased body mass index (BMI) in healthy subjects was significantly
associated with decreased TBV and GMV. In contrast, increased BMI in patients with
BD was significantly associated with decreased WMV and temporal lobe volume, areas
of known vulnerability in early BD.
Conclusions
This is the first published report to show a relationship between elevated BMI and
reduced brain volumes in BD, or any psychiatric illness. Our results suggest that
obesity is associated with unique neurobiological changes in BD. They further imply
a possible biological mechanism underlying the association between obesity and a more
severe illness course in BD.
Key Words
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Article info
Publication history
Published online: April 18, 2011
Accepted:
February 15,
2011
Received in revised form:
January 28,
2011
Received:
July 8,
2010
Identification
Copyright
© 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
