Daily Dose: Multimodal MRI Imaging Predicts Sex-specific Obesity Status

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On April 7, 2023, we reported on a study published in the journal Brain Communications that integrated data from multimodal brain imaging and behavioral data to determine sex-specific brain-behavioral signatures present in persons with obesity.

The study

The study included 183 participants aged 18-55 years who all completed multimodal neuroimaging, including morphometry, functional resting-state MRI, and a diffusion weighted scan. Also, participants completed a battery of behavioral and clinical questionnaires that assessed childhood trauma, anxiety and depression, visceral sensitivity, food addiction, bowel symptoms, personality traits, and several other factors. For the purpose of the study, participants were classified as “high body mass index (BMI)” if they had a BMI greater than 25 kg/m² and “nonobese BMI” if they had a BMI between 19-20 kg/m². Among the cohort there were 23 men and 55 women with high BMI and 42 men and 63 women with nonobese BMI.

The findings

The 4 main findings of the study were:

1. Greater choroid plexus and ventricular and volume in high BMI participants was associated with anatomical connectivity alterations in the cortico-basal ganglia-thalamo-cortical loop.

2. Greater trauma early in life was associated with greater volume and surface area as well as anatomical connectivity of the anterior insula and greater sensorimotor-default mode network resting-state connectivity.

3. When compared to men with high BMI, women with high BMI demonstrated lower mental health scores, which was associated with lower amygdala resting-state functional connectivity to the sensorimotor network.

4. When compared to men with high BMI, women with high BMI had greater scores on the Pennebaker Inventory of Limbic Languidness questionnaire, which were associated with lower surface area and volume in the anterior cingulate cortex.

Note from authors

"This study contributes to the understanding of the nuances driving the sex-specific pathophysiology of obesity. The ability to predict the sex-specific obesity status of an individual based on neural alterations lends itself to the future of individualized treatment plans and preventative medicine. Although causality is unknown, the strong associations between clinical markers, such as anxiety, depression, obesity, and neural signatures suggest the importance of the bidirectional mechanistic connection of the gut-brain axis."

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