Key result
Obesity was associated with decreased fractional anisotropy and increased mean diffusivity in the majority of 31 cross-sectional studies, suggesting white matter abnormalities.
Why the study?
Obesity is associated with alterations in brain structure, but findings on microstructural white matter changes using diffusion tensor imaging warranted systematic review.
Does obesity associate with microstructural white matter alterations measured by diffusion tensor imaging compared to lean controls?
Systematic Review
Does obesity associate with microstructural white matter alterations measured by diffusion tensor imaging compared to lean controls?
Obesity is associated with white matter abnormalities as measured by diffusion tensor imaging, though findings are inconsistent across studies.
Associates obesity with DTI white matter changes; leaves open causality, progression, and reversibility.
Obesity is a major global health problem leading to serious complications. It has been consistently associated with alterations in brain structure. Diffusion tensor imaging is used to examine brain white matter microstructure by assessing the dynamics of water diffusion in white matter tracts. Fractional anisotropy and mean diffusivity are two parameters measuring the directionality and rate of diffusion, respectively. Changes in these indices associated with obesity have been previously reported in numerous fiber tracts. This systematic review investigates microstructural white matter alterations in obesity using diffusion tensor imaging. A computerized search was performed in PubMed, Web of Science, and Livivo databases. Based on the inclusion/exclusion criteria, 31 cross-sectional studies comparing individuals with obesity and lean controls were identified. The studies included mixed-gender samples of children, young, middle-aged, and older adults. The majority of included studies reported decreased fractional anisotropy and increased mean diffusivity associated with elevated body mass index, suggesting white matter abnormalities. Nevertheless, a pattern of alterations is inconsistent across studies. This could be explained by several potential biases assessed by the National Institute of Health quality assessment tool. Furthermore, a direct assessment of body fat is recommended for a more accurate characterization of the brain-body relationship.
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Okudzhava et al. (2021) conducted a systematic review in Obesity. Obesity vs. Lean controls was evaluated on Microstructural white matter alterations (fractional anisotropy and mean diffusivity). Obesity was associated with decreased fractional anisotropy and increased mean diffusivity in the majority of 31 cross-sectional studies, suggesting white matter abnormalities.
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