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Obesity may have negative effects on white matter microstructure in schizophrenia

Key clinical point: Obesity is associated with sleep disturbances, daily dose of typical antipsychotics, and regional white matter microstructure impairments in patients with schizophrenia.

Major finding: Pittsburgh Sleep Quality Index score (P less than .05) and daily dose of typical antipsychotics (P less than .001) were significantly higher in obese vs. non-obese patients. In diffusion tensor imaging, white matter fractional anisotropy values in the corpus callosum, corona radiata, corticospinal tract, superior longitudinal fasciculus, and posterior thalamic radiations were significantly lower in obese vs. non-obese patients (P less than .05).

Study details: The findings are based on a study of 65 Japanese patients diagnosed with schizophrenia (mean age, 37.2±11.3 years; 32 females).

Disclosures: The study was supported by the Strategic Research Program for Brain Sciences from the Japan Agency for Medical Research and Development. The authors declared no conflicts of interest.


“Obesity has been reported to be associated a variety of with psychiatric disorders, including schizophrenia. This study, a first focused on Asian patients, examined the association of body mass index (BMI) -based obesity with whole-brain structure in Japanese patients with schizophrenia. The authors note that higher BMI may have negative effects on white matter microstructure in patients with schizophrenia and suggest that demyelination is promoted by obesity in terms of the white matter pathology of schizophrenia.

The clinical implications of the findings suggest that obesity may add to the burden that people with schizophrenia already experience with having a chronic psychotic disorder. Care strategies that aim to minimize obesity risk and burden may help to protect whole brain/whole body health among people with schizophrenia.”

Martha Sajatovic, MD
Professor of Psychiatry and of Neurology
Willard Brown Chair in Neurological Outcomes Research
Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center
Case Western Reserve University School of Medicine


Hidese S et al. Schizophr Res. 2020 Aug 5.