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The additive impact of cardio-metabolic disorders and psychiatric illnesses on accelerated brain aging.

ABSTRACT: Severe mental illnesses (SMI) including major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia spectrum disorder (SSD) elevate accelerated brain aging risks. Cardio-metabolic disorders (CMD) are common comorbidities in SMI and negatively impact brain health. We validated a linear quantile regression index (QRI) approach against the machine learning "BrainAge" index in an independent SSD cohort (N = 206). We tested the direct and additive effects of SMI and CMD effects on accelerated brain aging in the N = 1,618 (604 M/1,014 F, average age = 63.53 ± 7.38) subjects with SMI and N = 11,849 (5,719 M/6,130 F; 64.42 ± 7.38) controls from the UK Biobank. Subjects were subdivided based on diagnostic status: SMI+/CMD+ (N = 665), SMI+/CMD- (N = 964), SMI-/CMD+ (N = 3,765), SMI-/CMD- (N = 8,083). SMI (F = 40.47, p = 2.06 × 10^-10 ) and CMD (F = 24.69, p = 6.82 × 10^-7 ) significantly, independently impacted whole-brain QRI in SMI+. SSD had the largest effect (Cohen's d = 1.42) then BD (d = 0.55), and MDD (d = 0.15). Hypertension had a significant effect on SMI+ (d = 0.19) and SMI- (d = 0.14). SMI effects were direct, independent of MD, and remained significant after correcting for effects of antipsychotic medications. Whole-brain QRI was significantly (p < 10^-16 ) associated with the volume of white matter hyperintensities (WMH). However, WMH did not show significant association with SMI and was driven by CMD, chiefly hypertension (p < 10^-16 ). We used a simple and robust index, QRI, the demonstrate additive effect of SMI and CMD on accelerated brain aging. We showed a greater effect of psychiatric illnesses on QRI compared to cardio-metabolic illness. Our findings suggest that subjects with SMI should be among the targets for interventions to protect against age-related cognitive decline.

SUBMITTER: Ryan MC

PROVIDER: S-EPMC8933252 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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The additive impact of cardio-metabolic disorders and psychiatric illnesses on accelerated brain aging.

Ryan Meghann C MC Hong L Elliot LE Hatch Kathryn S KS Gao Si S Chen Shuo S Haerian Krystl K Wang Jingtao J Goldwaser Eric L EL Du Xiaoming X Adhikari Bhim M BM Bruce Heather H Hare Stephanie S Kvarta Mark D MD Jahanshad Neda N Nichols Thomas E TE Thompson Paul M PM Kochunov Peter P

Human brain mapping 20220203 6

Severe mental illnesses (SMI) including major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia spectrum disorder (SSD) elevate accelerated brain aging risks. Cardio-metabolic disorders (CMD) are common comorbidities in SMI and negatively impact brain health. We validated a linear quantile regression index (QRI) approach against the machine learning "BrainAge" index in an independent SSD cohort (N = 206). We tested the direct and additive effects of SMI and CMD effects on accel ...[more]

PMID: 35112422

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Project description:BACKGROUND:Across networks, connectivity within the frontoparietal network (FPN) and cingulo-opercular network (CON) exhibits reductions earliest during healthy aging, contributing to cognitive impairment. Individuals with psychotic disorders demonstrate evidence of accelerated aging across multiple biological systems. By leveraging a large sample of patients with psychosis from early to chronic illness stages, this study sought to determine whether the CON and FPN exhibit evidence of accelerated aging in psychotic disorders, confirm associations between network efficiency and cognition, and determine whether reduced network efficiency is observed in early-stage psychosis. METHODS:Resting-state functional magnetic resonance imaging and cognitive data were obtained on 240 patients with psychotic disorder and 178 healthy control participants (HCs). Global efficiency, a measure of functional integration, was calculated for the CON, FPN, subcortical network, and visual network. Associations with age and cognition were assessed and compared between groups. RESULTS:Consistent with accelerated aging, significant group by age interactions reflected significantly stronger relationships between efficiency and age in patients with psychosis than in HCs for both the CON (psychosis: r = -.37; HC: r = -.16) and FPN (psychosis: r = -.31; HC: r = -.05). Accelerated aging was not observed in either the subcortical or visual network, suggesting specificity for cognitive networks that decline earliest in healthy aging. Replicating prior findings, efficiency of both the CON and FPN correlated with cognitive function across all participants (rs > .11, ps < .031). Furthermore, patients with chronic psychosis (p = .004), but not patients with early psychosis (p = .553), exhibited significantly lower FPN efficiency compared with HCs. CONCLUSIONS:Functional integration of higher-order cognitive networks is intact in early psychosis but exhibits evidence of accelerated aging, suggesting the potential for intervention targeting cognition within the early psychosis period.

Project description:Lifestyle changes involving high caloric diet, sedentary life, and/or persistent stress appear to play a role in the onset of metabolic syndrome (MetS), which is characterized by hyperglycemia, hyperinsulinemia, dyslipidemia, obesity, and type-2 diabetes. MetS in the long run appears to have cerebrovascular consequences, resulting in neuropsychiatric disorders. However, there is a paucity of molecular studies using relevant animal models of metabolic disorder-induced neuropsychiatric disorders. Here, we tried to model the clinical conditions of MetS by feeding C57bl/6 Ncrl mice a high fructose diet (Hfr) for almost 12 months. Random glucose, fasting glucose, glucose tolerance, and triglycerides did not differ significantly between the Hfr diet and Control diet (Cont) groups even after a year on the Hfr diet, except for the accelerated aging-like phenotype in coat color and shiny texture. However, exposure to chronic stress for a week induced metabolic disorder as reflected in high post-prandial blood glucose in the Hfr group, and subsequently mood disorder (depression and anxiety) (p<0.01) and cognitive disorder (p<0.01) as indicated by the behavioral tests. To uncover the underlying molecular mechanisms in the prefrontal cortex, a transcriptomic study was performed. The data analysis revealed hundreds of differentially expressed genes (DEGs) between the groups (i.e., HfrUST vs CoUST = 348 genes; CoST vs CoUST = 496 genes; HfrST vs HfrUST =226 genes and HfrST vs CoST= 18 genes). The pattern of gene expression was strikingly different in the HfrST group compared to the Ctrl group, thus correlating the phenotype, i.e. MetS induced mood and cognitive disorders. Pathway analysis of the DEGs indicated perturbations in cellular metabolism, inflammation, innate immunity, neurogenesis, vasculogenesis, ion channels, and neuronal signaling. In addition, altered epigenetic regulators appear to mediate the stress-induced precipitation of metabolic and neuropsychiatric disorders. The outcome of our study supports the hypothesis of disease susceptibility due to lifestyle changes involving a high-calorie diet and chronic stress.

Project description:ObjectiveIt is not clear why psychiatric disorders are more prevalent in the functional somatic syndromes than other general medical illnesses. This study assessed the correlates of psychiatric disorders in 3 functional syndromes and 3 general medical illnesses in a population-based sample.MethodsThe Lifelines cohort study included 122,366 adults with relevant data for 6 self-reported conditions: irritable bowel syndrome (IBS), fibromyalgia, chronic fatigue syndrome (CFS), inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and diabetes. For each condition the proportion with a DSM-IV psychiatric disorder was assessed. In a cross-sectional design, logistic regression identified at baseline the variables most closely associated with current psychiatric disorder in participants with a pre-existing medical or functional condition. In a separate analysis the prevalence of psychiatric disorder prior to onset of these conditions was assessed. This was a longitudinal study with psychiatric disorder assessed at baseline in participants who subsequently developed a general medical or functional condition between baseline and follow-up.ResultsThe prevalence of psychiatric disorder was higher (17-27%) in the functional somatic syndromes than the general medical illnesses (10.4-11.7%). The variables closely associated with psychiatric disorder were similar in the functional syndromes and general medical illnesses: stressful life events, chronic personal health difficulties, neuroticism, poor perception of general health, impairment of function due to physical illness and reported previous (lifetime) psychiatric disorder. The prevalence of psychiatric disorder prior to development of these disorder was similar to that of established disorders.ConclusionDespite the difference in prevalence, the correlates of psychiatric disorders were similar in functional and general medical disorders and included predisposing and environmental factors. The increased rate of psychiatric disorder in functional somatic syndromes appears to be evident before onset of the syndrome.

Project description:ObjectiveIn both children and adults, psychiatric illness is associated with structural brain alterations, particularly in the prefrontal cortex (PFC). However, most studies compare gray matter volume (GMV) in healthy volunteers (HVs) to one psychiatric group. We compared GMV among youth with anxiety disorders, bipolar disorder (BD), disruptive mood dysregulation disorder (DMDD), attention-deficit/hyperactivity disorder (ADHD), and HVs.Method3-Tesla T1-weighted magnetic resonance imaging scans were acquired in 184 youths (39 anxious, 20 BD, 52 DMDD, 20 ADHD, and 53 HV). Voxel-based morphometry analyses were conducted. One-way analysis of variance tested GMV differences with whole-brain familywise error (p < .05) correction; secondary, exploratory whole-brain analyses used a threshold of p < .001, ≥200 voxels. Given recent frameworks advocating dimensional approaches in psychopathology research, we also tested GMV associations with continuous anxiety, irritability, and inattention symptoms.ResultsSpecificity emerged in the left dorsolateral PFC (dlPFC), which differed among youth with BD, anxiety, and HVs; GMV was increased in youth with anxiety, but decreased in BD, relative to HVs. Secondary analyses revealed BD-specific GMV decreases in the right lateral PFC, right dlPFC, and dorsomedial PFC, and also anxiety-specific GMV increases in the left dlPFC, right ventrolateral PFC, frontal pole, and right parahippocampal gyrus/lingual gyrus. Both BD and DMDD showed decreased GMV relative to HVs in the right dlPFC/superior frontal gyrus. GMV was not associated with dimensional measures of anxiety, irritability, or ADHD symptoms.ConclusionBoth disorder-specific and shared GMV differences manifest in pediatric psychopathology. Some differences were specific to anxiety disorders, others specific to BD, and others shared between BD and DMDD. Further developmental research might map commonalities and differences of structure and function in diverse pediatric psychopathologies.

Dataset Information

The additive impact of cardio-metabolic disorders and psychiatric illnesses on accelerated brain aging.

Publications

The additive impact of cardio-metabolic disorders and psychiatric illnesses on accelerated brain aging.

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