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Neurococognitive and neuroimaging correlates of obesity and components of metabolic syndrome in bipolar disorder: a systematic review

Published online by Cambridge University Press:  17 October 2018

Emre Bora ,
Roger S. McIntyre  and
Aysegul Ozerdem
Emre Bora*
Affiliation:
Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
Roger S. McIntyre
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, ON, Canada Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
Aysegul Ozerdem
Affiliation:
Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
*
Author for correspondence: Emre Bora, E-mail: emrebora@hotmail.com, emre.bora@deu.edu.tr
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Abstract

Background

Individuals with bipolar disorder (BD) have a higher prevalence of obesity and metabolic syndrome (MetS) compared with the general population. Obesity and MetS are associated with cognitive deficits and brain imaging abnormalities in the general population. Obesity and components of MetS might potentially associate with neuroimaging and neurocognitive findings in BD.

Methods

A literature search of studies investigating the association between obesity (and other components of MetS) and neurocognitive and neuroimaging findings in BD was conducted. In addition to a systematic review, a random-effects meta-analysis was conducted when sufficient data were available.

Results

Twenty-three studies were included in the current systematic review. Overweight/obese patients were significantly associated with impaired neurocognition compared normal weight individuals with BD (d = 0.37). The most robust association between obesity and cognitive deficits in BD was observed in the cognitive subdomain of executive functions (d = 0.61). There was also evidence for a significant relationship between cognitive impairment in BD and other components of MetS including hypertension, dyslipidemia, and diabetes. Overweight/obese individuals with BD had more pronounced brain imaging abnormalities than normal weight individuals with BD.

Conclusions

Obesity and related cardiovascular risk factors significantly are associated with more severe cognitive and brain imaging abnormalities in BD. Medical co-morbidities can potentially contribute to functional decline observed in some patients throughout the course of BD.

Keywords

Bipolar disordercognitionhypertensionmeta-analysismetabolic syndromeMRIobesitysystematic review
Type
Review Article
Information
Psychological Medicine , Volume 49 , Issue 5 , April 2019 , pp. 738 - 749
Copyright
Copyright © Cambridge University Press 2018 

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