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Zhou Q, Zhu W, Cai X, Jing J, Wang M, Wang S, Jin A, Meng X, Wei T, Wang Y, Pan Y. Obesity and brain volumes: mediation by cardiometabolic and inflammatory measures. Stroke Vasc Neurol 2025; 10:e003045. [PMID: 39160093 DOI: 10.1136/svn-2023-003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/25/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between overall obesity, central obesity and brain volumes, as well as to determine the extent to which cardiometabolic and inflammatory measures act as mediators in the association between body mass index (BMI), waist-hip ratio (WHR) and brain volumes. METHODS In the context of counterfactual framework, mediation analysis was used to explore the potential mediation in which cardiometabolic and inflammatory measures may mediate the relationship between BMI, WHR, and brain volumes. RESULTS Among 2413 community-dwelling participants, those with high BMI or WHR levels experienced an approximately brain ageing of 4 years. Especially, individuals with high WHR or BMI under the age of 65 exhibited white matter hyperintensity volume (WMHV) differences equivalent to around 5 years of ageing. Conversely, in the high-level WHR population over the age of 65, premature brain ageing in gray matter volume (GMV) exceeded 4.5 years. For GMV, more than 45% of the observed effect of WHR was mediated by glycaemic metabolism indicators. This proportion increases to 78.70% when blood pressure, triglyceride, leucocyte count, and neutrophil count are jointly considered with glycaemic metabolism indicators. Regarding WHR and BMI's association with WMHV, cardiometabolic and inflammatory indicators, along with high-density lipoprotein cholesterol, mediated 35.50% and 20.20% of the respective effects. CONCLUSIONS Overall obesity and central obesity were associated with lower GMV and higher WMHV, a process that is partially mediated by the presence of cardiometabolic and inflammatory measures.
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Affiliation(s)
- Qi Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wanlin Zhu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xueli Cai
- Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
- Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Mengxing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Suying Wang
- Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China
| | - Aoming Jin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tiemin Wei
- Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, 2019RU018, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Odkhuu S, Tang X, Kim WS, Wei Y, Xu L, Cui H, Tang Y, Wang J, Lee KH, Kang NI, Zhang T, Chung YC. Brain Network Resilience and Cognitive Function in Patients with First Episode Schizophrenia Spectrum Disorders. Biol Psychiatry 2025:S0006-3223(25)01104-7. [PMID: 40169082 DOI: 10.1016/j.biopsych.2025.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 03/13/2025] [Accepted: 03/19/2025] [Indexed: 04/03/2025]
Abstract
BACKGROUND First-episode schizophrenia spectrum disorders (FESSDs) are associated with significant cognitive impairment that affects daily functioning. While these deficits are well-documented, the neural mechanisms underlying the cognitive impairment in FESSDs remain limited. As the structure robustness and resilience of the brain network in healthy population are reported to be associated with cognitive function, we examined these associations in FESSDs. METHODS This study investigated the relationships of the structure robustness and resilience of the core brain network with cognitive function and psychopathology in patients with FESSDs (n = 340) using data from two independent cohorts in South Korea and China. Age- and sex-matched HC (n = 420) were also recruited. We applied advanced k-shell decomposition techniques to functional brain networks and estimated various measures of structure robustness and resilience. RESULTS Patients with FESSDs had brain networks with a less robust structure and resilience than those of HC. Resilience measures were positively correlated with executive function in patients. Core brain network structure and k-core resilience were negatively correlated with the Positive and Negative Syndrome Scale scores. Subgroup analysis showed that structure robustness and resilience at each site matched the main analysis, but correlations with cognitive function and psychopathology were observed only in the South Korea cohort. CONCLUSIONS Better preservation of brain network structure and resilience is associated with higher cognitive function and milder clinical symptoms in patients with FESSDs. This highlights potential targets for therapeutic interventions aimed at enhancing cognitive function and improving the symptoms of FESSDs.
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Affiliation(s)
- Soyolsaikhan Odkhuu
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - Woo-Sung Kim
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - HuiRu Cui
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - YingYing Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China; Department of Psychiatry, Nantong Fourth People's Hospital & Nantong Brain Hospital, Suzhou, 226000, China
| | - Keon-Hak Lee
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea
| | - Nam-In Kang
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea
| | - TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China.
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea; Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
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