Introduction
Childhood obesity is increasingly prevalent and confers elevated risk of developing medical complications across the lifespan. Given the brain's prominent involvement in homeostatic and hedonic eating, it is crucial to understand brain health in obesity. Recent studies using quantitative T2-weighted MRI and diffusion-weighted MRI showed obesity-related putative neuroinflammation in human brain. To assess convergent validity across diffusion-based MRI techniques and extend these findings, this study characterized tissue microstructure of white matter (WM) tracts and energy regulation and reward processing brain regions in children across levels of obesity-related measures, using diffusion basis spectrum imaging (DBSI).
Methods
Using data from the Adolescent Brain Cognitive Development Study (ABCD Study®), DBSI metrics indicative of putative neuroinflammation were computed for WM tracts, hypothalamus, nucleus accumbens, caudate nucleus, and putamen. DBSI metrics were compared between children with normal-weight vs. obesity. DBSI metrics were also correlated to baseline and one- and two-year change in continuous obesity-related measures (waist circumference, BMI, and BMI z-scores). Striatal DBSI findings were compared to those of restriction spectrum imaging (RSI).
Results
A total of 263 nine- and ten-year old children from the ABCD Study® 2.0.1 data release (5 underweight; 126 with normal-weight; 64 with over-weight; 68 with obesity) who met inclusion and exclusion criteria were randomly selected. Relative to children with normal-weight, children with obesity had lower DBSI fiber fraction (FF; reflects apparent axonal/dendritic density) and higher DBSI restricted fraction (RF; reflects cellularity) in WM tracts throughout the brain (voxel-wise FWE-corrected p < 0.05), as well as higher DBSI-RF in the hypothalamus, nucleus accumbens, and caudate nucleus (Cohen's d's ≥ 0.28, p's ≤ 0.05). Across all children, greater baseline waist circumference was related to higher DBSI-RF in the hypothalamus (standardized β = 0.17, p = 0.0033), nucleus accumbens (standardized β = 0.21, p = 0.0001), and caudate nucleus (standardized β = 0.14, p = 0.013). Gain in waist circumference over one and two years related to higher baseline DBSI-RF in nucleus accumbens (standardized β = 0.12, p = 0.08) and in hypothalamus (standardized β = 0.15, p = 0.03), respectively. Overall, results were consistent for BMI and BMI z-scores. Similar results were observed using RSI metrics.
Conclusion
Novel findings include demonstration that, as in adults, childhood obesity is associated with DBSI-assessed putative neuroinflammation in WM tracts and hypothalamus. In addition, our results support the reproducibility of previous findings that MRI-assessed putative neuroinflammation in striatum and hypothalamus is related to obesity in children, contributing to a growing understanding of the role of adiposity in brain health across the lifespan.