INTRODUCTION: Obesity and dyslipidemia may negatively affect brain health and are frequent medical comorbidities of schizophrenia and related disorders. Despite the high burden of metabolic disorders, little is known about their effects on brain structure in psychosis. We investigated, whether obesity or dyslipidemia contributed to brain alterations in first-episode psychosis (FEP). METHODS: 120 participants with FEP, who were undergoing their first psychiatric hospitalization, had <24 months of untreated psychosis and were 18-35 years old and 114 controls within the same age range participated in the study. We acquired 3T brain structural MRI, fasting lipids and body mass index. We used machine learning trained on an independent sample of 504 controls to estimate the individual brain age of study participants and calculated the BrainAGE score by subtracting the chronological from the estimated brain age. RESULTS: In a multiple regression model, the diagnosis of FEP (B = 1.15, SE B = 0.31, p < 0.001) and obesity/overweight (B = 0.92, SE B = 0.35, p = 0.008) were each additively associated with BrainAGE scores (R2 = 0.22, F(3, 230) = 21.92, p < 0.001). BrainAGE scores were highest in participants with FEP and obesity/overweight (3.83 years, 95%CI = 2.35-5.31) and lowest in normal weight controls (-0.27 years, 95%CI = -1.22-0.69). LDL-cholesterol, HDL-cholesterol or triglycerides were not associated with BrainAGE scores. CONCLUSIONS: Overweight/obesity may be an independent risk factor for diffuse brain alterations manifesting as advanced brain age already early in the course of psychosis. These findings raise the possibility that targeting metabolic health and intervening already at the level of overweight/obesity could slow brain ageing in FEP.

3rd School of Medicine Charles University Ruská 87 100 00 Prague Czech Republic

Dalhousie University Department of Psychiatry 5909 Veteran's Memorial Lane Halifax NS B3H 2E2 Canada

Institute of Computer Science Czech Academy of Sciences Pod Vodarenskou Vezi 271 2 182 07 Prague Czech Republic

National Institute of Mental Health Topolová 748 250 67 Klecany Czech Republic

Psychiatric Hospital Bohnice Ústavní 91 181 00 Prague Czech Republic

Psychiatric Hospital Kosmonosy Lípy 15 293 06 Kosmonosy Czech Republic

Structural Brain Mapping Group Department of Neurology Jena University Hospital Erlanger Alle 101 D 07747 Jena Germany

The Hospital for Sick Children University of Toronto 686 Bay Street 10 9705 Toronto ON M5G 0A4 Canada

Citace poskytuje Crossref.org