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

Published online by Cambridge University Press:  12 March 2021

David J. Bond Open the ORCID record for David J. Bond [Opens in a new window] ,
Leonardo E. Silveira ,
Ivan J. Torres Open the ORCID record for Ivan J. Torres [Opens in a new window] ,
Raymond W. Lam Open the ORCID record for Raymond W. Lam [Opens in a new window]  and
Lakshmi N. Yatham Open the ORCID record for Lakshmi N. Yatham [Opens in a new window]
David J. Bond
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
Leonardo E. Silveira
Affiliation:
Laboratory of Molecular Psychiatry, Centro de Pesquisas Experimentais, Hospital de Clínicas de Porto Alegre, and INCT for Translational Medicine, Porto Alegre, RS, Brazil
Ivan J. Torres
Affiliation:
Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
Raymond W. Lam
Affiliation:
Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
Lakshmi N. Yatham*
Affiliation:
Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
*
Author for correspondence: Lakshmi N. Yatham, E-mail: [email protected]
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Abstract

Background

We previously reported that bipolar disorder (BD) patients with clinically significant weight gain (CSWG; ⩾7% 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 Δleft 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.

Keywords

Bipolar disorderbody mass indexglutamatehippocampusmagnetic resonance spectroscopyN-acetylaspartate
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 16 , December 2022 , pp. 3783 - 3791
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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