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Obesity as a Risk Factor for Accelerated Brain Ageing in First-Episode Psychosis—A Longitudinal Study
- Source :
- Schizophr Bull
- Publication Year :
- 2021
- Publisher :
- Oxford University Press (OUP), 2021.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 17451701 and 05867614
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Schizophrenia Bulletin
- Accession number :
- edsair.doi.dedup.....1349ec636c3bdd34b1d11850cd100188