Weight gain as a risk factor for progressive neurochemical abnormalities in first episode mania patients: A longitudinal magnetic resonance spectroscopy study

David J. Bond, Leonardo E. Silveira, Ivan J. Torres, Raymond W. Lam, Lakshmi N. Yatham

Research output: Contribution to journalArticlepeer-review

Abstract

Background We previously reported that bipolar disorder (BD) patients with clinically significant weight gain (CSWG; 3/47% of baseline weight) in the 12 months after their first manic episode experienced greater limbic brain volume loss than patients without CSWG. It is unknown whether CSWG is also a risk factor for progressive neurochemical abnormalities. Methods We investigated whether 12-month CSWG predicted greater 12-month decreases in hippocampal N-acetylaspartate (NAA) and greater increases in glutamate + glutamine (Glx) following a first manic episode. In BD patients (n = 58) and healthy comparator subjects (HS; n = 34), we measured baseline and 12-month hippocampal NAA and Glx using bilateral 3-Tesla single-voxel proton magnetic resonance spectroscopy. We used general linear models for repeated measures to investigate whether CSWG predicted neurochemical changes. Results Thirty-three percent of patients and 18% of HS experienced CSWG. After correcting for multiple comparisons, CSWG in patients predicted a greater decrease in left hippocampal NAA (effect size = -0.52, p = 0.005). CSWG also predicted a greater decrease in left hippocampal NAA in HS with a similar effect size (-0.53). A model including patients and HS found an effect of CSWG on "left NAA (p = 0.007), but no diagnosis effect and no diagnosis × CSWG interaction, confirming that CSWG had similar effects in patients and HS. Conclusion CSWG is a risk factor for decreasing hippocampal NAA in BD patients and HS. These results suggest that the well-known finding of reduced NAA in BD may result from higher body mass index in patients rather than BD diagnosis.

Original languageEnglish (US)
Number of pages9
JournalPsychological medicine
Early online dateMar 12 2021
DOIs
StateE-pub ahead of print - Mar 12 2021

Bibliographical note

Publisher Copyright:
Copyright © The Author(s), 2021. Published by Cambridge University Press.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • Bipolar disorder
  • body mass index
  • glutamate
  • hippocampus
  • magnetic resonance spectroscopy
  • N-acetylaspartate

PubMed: MeSH publication types

  • Journal Article

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