Obesity and brain structure in schizophrenia - ENIGMA study in 3021 individuals

Sean R McWhinney, Katharina Brosch, Vince D Calhoun, Benedicto Crespo-Facorro, Nicolas A Crossley, Udo Dannlowski, Erin Dickie, Lorielle M F Dietze, Gary Donohoe, Stefan Du Plessis, Stefan Ehrlich, Robin Emsley, Petra Furstova, David C Glahn, Alfonso Gonzalez-Valderrama, Dominik Grotegerd, Laurena Holleran, Tilo T J Kircher, Pavel Knytl, Marian KolenicRebekka Lencer, Igor Nenadić, Nils Opel, Julia-Katharina Pfarr, Amanda L Rodrigue, Kelly Rootes-Murdy, Alex J Ross, Kang Sim, Antonín Škoch, Filip Spaniel, Frederike Stein, Patrik Švancer, Diana Tordesillas-Gutiérrez, Juan Undurraga, Javier Váquez-Bourgon, Aristotle Voineskos, Esther Walton, Thomas W Weickert, Cynthia Shannon Weickert, Paul M Thompson, Theo G M van Erp, Jessica A Turner, Tomas Hajek

Research output: Contribution to journalArticlepeer-review

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Schizophrenia is frequently associated with obesity, which is linked with neurostructural alterations. Yet, we do not understand how the brain correlates of obesity map onto the brain changes in schizophrenia. We obtained MRI-derived brain cortical and subcortical measures and body mass index (BMI) from 1260 individuals with schizophrenia and 1761 controls from 12 independent research sites within the ENIGMA-Schizophrenia Working Group. We jointly modeled the statistical effects of schizophrenia and BMI using mixed effects. BMI was additively associated with structure of many of the same brain regions as schizophrenia, but the cortical and subcortical alterations in schizophrenia were more widespread and pronounced. Both BMI and schizophrenia were primarily associated with changes in cortical thickness, with fewer correlates in surface area. While, BMI was negatively associated with cortical thickness, the significant associations between BMI and surface area or subcortical volumes were positive. Lastly, the brain correlates of obesity were replicated among large studies and closely resembled neurostructural changes in major depressive disorders. We confirmed widespread associations between BMI and brain structure in individuals with schizophrenia. People with both obesity and schizophrenia showed more pronounced brain alterations than people with only one of these conditions. Obesity appears to be a relevant factor which could account for heterogeneity of brain imaging findings and for differences in brain imaging outcomes among people with schizophrenia.

Original languageEnglish
Pages (from-to)3731-3737
Number of pages7
JournalMolecular Psychiatry
Issue number9
Early online date14 Jun 2022
Publication statusPublished - 30 Sept 2022

ASJC Scopus subject areas

  • Molecular Biology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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