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We previously reported that patients with early-stage bipolar disorder,
but not healthy comparison controls, had body mass index (BMI)-related
volume reductions in limbic brain areas, suggesting that the structural
brain changes characteristic of bipolar disorder were more pronounced
with increased weight.
To determine whether the most consistently reported neurochemical
abnormality in bipolar disorder, increased glutamate/glutamine (Glx), was
also more prominent with higher BMI.
We used single-voxel proton magnetic resonance spectroscopy to measure
hippocampal Glx in 51 patients with first-episode mania (mean BMI = 24.1)
and 28 healthy controls (mean BMI = 23.3).
In patients, but not healthy controls, linear regression demonstrated
that higher BMI predicted greater Glx. Factorial ANCOVA showed a
significant BMI×diagnosis interaction, confirming a distinct effect of
weight on Glx in patients.
Together with our volumetric studies, these results suggest that higher
BMI is associated with more pronounced structural and neurochemical
limbic brain changes in bipolar disorder, even in early-stage patients
with low obesity rates.
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