Obesity as a Risk Factor for Accelerated Brain Ageing in First-Episode Psychosis—A Longitudinal Study
| Autor: | Tomas Hajek, Sean R. McWhinney, Katja Franke, Pavel Knytl, Marketa Fialova, Martin Matejka, Filip Spaniel, Marian Kolenic |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Psychosis Longitudinal study Pediatrics medicine.medical_specialty Adolescent Global Assessment of Functioning Body Mass Index Machine Learning Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Longitudinal Studies Obesity Risk factor 2. Zero hunger First episode Positive and Negative Syndrome Scale business.industry Aging Premature medicine.disease Magnetic Resonance Imaging 3. Good health 030227 psychiatry Psychiatry and Mental health Psychotic Disorders Ageing Schizophrenia Disease Progression Female business 030217 neurology & neurosurgery Regular Articles |
| Zdroj: | Schizophr Bull |
| ISSN: | 1745-1701 0586-7614 |
| DOI: | 10.1093/schbul/sbab064 |
| Popis: | Background Obesity is highly prevalent in schizophrenia, with implications for psychiatric prognosis, possibly through links between obesity and brain structure. In this longitudinal study in first episode of psychosis (FEP), we used machine learning and structural magnetic resonance imaging (MRI) to study the impact of psychotic illness and obesity on brain ageing/neuroprogression shortly after illness onset. Methods We acquired 2 prospective MRI scans on average 1.61 years apart in 183 FEP and 155 control individuals. We used a machine learning model trained on an independent sample of 504 controls to estimate the individual brain ages of study participants and calculated BrainAGE by subtracting chronological from the estimated brain age. Results Individuals with FEP had a higher initial BrainAGE than controls (3.39 ± 6.36 vs 1.72 ± 5.56 years; β = 1.68, t(336) = 2.59, P = .01), but similar annual rates of brain ageing over time (1.28 ± 2.40 vs 1.07±1.74 estimated years/actual year; t(333) = 0.93, P = .18). Across both cohorts, greater baseline body mass index (BMI) predicted faster brain ageing (β = 0.08, t(333) = 2.59, P = .01). For each additional BMI point, the brain aged by an additional month per year. Worsening of functioning over time (Global Assessment of Functioning; β = −0.04, t(164) = −2.48, P = .01) and increases especially in negative symptoms on the Positive and Negative Syndrome Scale (β = 0.11, t(175) = 3.11, P = .002) were associated with faster brain ageing in FEP. Conclusions Brain alterations in psychosis are manifest already during the first episode and over time get worse in those with worsening clinical outcomes or higher baseline BMI. As baseline BMI predicted faster brain ageing, obesity may represent a modifiable risk factor in FEP that is linked with psychiatric outcomes via effects on brain structure. |
| Databáze: | OpenAIRE |
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