Article

Brain Structure and Obesity

Department of Pathology, University of Pittsburgh, Pennsylvania, USA.
Human Brain Mapping (Impact Factor: 6.92). 11/2009; 31(3):353-64. DOI: 10.1002/hbm.20870
Source: PubMed

ABSTRACT Obesity is associated with increased risk for cardiovascular health problems including diabetes, hypertension, and stroke. These cardiovascular afflictions increase risk for cognitive decline and dementia, but it is unknown whether these factors, specifically obesity and Type II diabetes, are associated with specific patterns of brain atrophy. We used tensor-based morphometry (TBM) to examine gray matter (GM) and white matter (WM) volume differences in 94 elderly subjects who remained cognitively normal for at least 5 years after their scan. Bivariate analyses with corrections for multiple comparisons strongly linked body mass index (BMI), fasting plasma insulin (FPI) levels, and Type II Diabetes Mellitus (DM2) with atrophy in frontal, temporal, and subcortical brain regions. A multiple regression model, also correcting for multiple comparisons, revealed that BMI was still negatively correlated with brain atrophy (FDR <5%), while DM2 and FPI were no longer associated with any volume differences. In an Analysis of Covariance (ANCOVA) model controlling for age, gender, and race, obese subjects with a high BMI (BMI > 30) showed atrophy in the frontal lobes, anterior cingulate gyrus, hippocampus, and thalamus compared with individuals with a normal BMI (18.5-25). Overweight subjects (BMI: 25-30) had atrophy in the basal ganglia and corona radiata of the WM. Overall brain volume did not differ between overweight and obese persons. Higher BMI was associated with lower brain volumes in overweight and obese elderly subjects. Obesity is therefore associated with detectable brain volume deficits in cognitively normal elderly subjects.

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    • "Recent work indicates that elderly women with high BMIs have greater temporal lobe atrophy -a fact that might explain the increased risk of Alzheimer's disease in this population (Gunstad et al., 2008). However, even in elderly males and females who do not have cognitive impairments, high fat tissue may have an adverse effect on brain structure leading to subsequent atrophy and dementia (Hassing et al., 2009; Raji et al., 2010). "
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    • "Accordingly, findings have suggested a negative association between childhood obesity and components of cognitive control; including inhibition (Kamijo, Kahn, et al., 2012; Kamijo, Pontifex, et al., 2012), working memory (Li et al., 2008), and cognitive flexibility (Cserjési et al., 2007; Lokken et al., 2009). Further, findings from a number of recent neuroimaging studies have indicated negative associations between BMI and gray matter volume in neural areas sub-serving aspects of cognitive control in adult populations (Maayan, Hoogendoorn, Sweat, & Convit, 2011; Raji et al., 2010). Interestingly, lower-levels of aerobic fitness have also been previously found to be associated with decreased cognitive performance across a variety of tasks, with a selectively greater deficit for aspects of cognitive control (Chaddock, Hillman et al., 2012; Hillman, Buck, Themanson, Pontifex, & Castelli, 2009; Kamijo et al., 2011; Pontifex et al., 2011; but see Hillman et al., 2008 for review). "
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    • "Interestingly, insulin resistance and obesity are known to cause changes in brain structure. Brain imaging studies have demonstrated that obesity may be associated with both generalized and regional brain atrophy, as well as structural changes in white matter and cerebral cortex (Jagust 2007; Raji et al. 2010; Marques-Iturria et al. 2013; Hassenstab et al. 2012). Type 2 diabetes is also associated with structural brain changes, such as decreases in hippocampal volume (Kamiyama et al. 2010), total brain volume (Schmidt et al. 2004) and cortical thickness (Ajilore et al. 2010; van Velsen et al. 2013). "
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