Clinical and neuroimaging correlates of cardiorespiratory fitness in adolescents with bipolar disorder
Introduction Cardiovascular disease (CVD) is exceedingly prevalent, and occurs prematurely in individuals with bipolar disorder (BD). Cardiorespiratory fitness (CRF), arguably the most important modifiable CVD risk factor, is also associated with brain structure and function. There is a gap in knowl...
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| Veröffentlicht in: | Bipolar disorders 2021-05, Vol.23 (3), p.274-283 |
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| creator | Popel, Najla Kennedy, Kody G. Fiksenbaum, Lisa Mitchell, Rachel H. B. MacIntosh, Bradley J. Goldstein, Benjamin I. |
| description | Introduction
Cardiovascular disease (CVD) is exceedingly prevalent, and occurs prematurely in individuals with bipolar disorder (BD). Cardiorespiratory fitness (CRF), arguably the most important modifiable CVD risk factor, is also associated with brain structure and function. There is a gap in knowledge regarding CRF in BD, particularly in relation to brain structure.
Methods
Adolescents with BD (n = 54) and healthy controls (HC; n = 53) completed semi‐structured diagnostic interviews, self‐report questionnaires, and 20 minutes of cardiorespiratory exercise at 60‐80% of estimated maximum heart rate (HR) on a bicycle ergometer. Average power (watts/kg) within this HR range served as a previously validated proxy for CRF. Brain magnetic resonance imaging (MRI) structural analysis was done using FreeSurfer. Analyses controlled for age and sex.
Results
CRF was significantly lower in BD vs HC (0.91 ± 0.32 vs 1.01 ± 0.30, p = 0.03, F = 4.66, df=1, η2=0.04). Within BD, greater depression symptoms were associated with lower CRF (P = .02), and greater physical activity (PA) was associated with greater CRF (P BD; P = .03) and sex (M > F; P |
| doi_str_mv | 10.1111/bdi.12993 |
| format | Article |
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Cardiovascular disease (CVD) is exceedingly prevalent, and occurs prematurely in individuals with bipolar disorder (BD). Cardiorespiratory fitness (CRF), arguably the most important modifiable CVD risk factor, is also associated with brain structure and function. There is a gap in knowledge regarding CRF in BD, particularly in relation to brain structure.
Methods
Adolescents with BD (n = 54) and healthy controls (HC; n = 53) completed semi‐structured diagnostic interviews, self‐report questionnaires, and 20 minutes of cardiorespiratory exercise at 60‐80% of estimated maximum heart rate (HR) on a bicycle ergometer. Average power (watts/kg) within this HR range served as a previously validated proxy for CRF. Brain magnetic resonance imaging (MRI) structural analysis was done using FreeSurfer. Analyses controlled for age and sex.
Results
CRF was significantly lower in BD vs HC (0.91 ± 0.32 vs 1.01 ± 0.30, p = 0.03, F = 4.66, df=1, η2=0.04). Within BD, greater depression symptoms were associated with lower CRF (P = .02), and greater physical activity (PA) was associated with greater CRF (P < .001). In multivariable analyses, there were significant main effects of diagnosis (HC>BD; P = .03) and sex (M > F; P < .001) on power. Significant predictors of power within BD included male sex (P = .02) and PA (P = .002) but not depression symptoms (P = .29). Significant diagnosis by CRF interaction effects was found in frontal, parietal, and occipital cortical regions.
Conclusion
CRF was reduced among adolescents with BD, particularly women, related in part to depression symptoms and inactivity and was differentially associated with regional brain structure. Studies seeking to improve CRF as a means of reducing psychiatric symptoms of BD are warranted.</description><identifier>ISSN: 1398-5647</identifier><identifier>EISSN: 1399-5618</identifier><identifier>DOI: 10.1111/bdi.12993</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>adolescent ; Adolescents ; Bipolar disorder ; Cardiorespiratory fitness ; Cardiovascular diseases ; Diagnosis ; Functional anatomy ; Heart rate ; Mental depression ; Neuroimaging ; Physical activity ; Physical fitness ; Risk factors ; Sex ; Structure-function relationships ; Teenagers</subject><ispartof>Bipolar disorders, 2021-05, Vol.23 (3), p.274-283</ispartof><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>Copyright © 2021 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3303-f61f46c4a38dcfe1d15fad4b086ef296875c50b571dff91e86bbddf3ae001e7a3</citedby><cites>FETCH-LOGICAL-c3303-f61f46c4a38dcfe1d15fad4b086ef296875c50b571dff91e86bbddf3ae001e7a3</cites><orcidid>0000-0003-0340-349X ; 0000-0002-6361-0469 ; 0000-0003-2215-1224</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbdi.12993$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbdi.12993$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids></links><search><creatorcontrib>Popel, Najla</creatorcontrib><creatorcontrib>Kennedy, Kody G.</creatorcontrib><creatorcontrib>Fiksenbaum, Lisa</creatorcontrib><creatorcontrib>Mitchell, Rachel H. B.</creatorcontrib><creatorcontrib>MacIntosh, Bradley J.</creatorcontrib><creatorcontrib>Goldstein, Benjamin I.</creatorcontrib><title>Clinical and neuroimaging correlates of cardiorespiratory fitness in adolescents with bipolar disorder</title><title>Bipolar disorders</title><description>Introduction
Cardiovascular disease (CVD) is exceedingly prevalent, and occurs prematurely in individuals with bipolar disorder (BD). Cardiorespiratory fitness (CRF), arguably the most important modifiable CVD risk factor, is also associated with brain structure and function. There is a gap in knowledge regarding CRF in BD, particularly in relation to brain structure.
Methods
Adolescents with BD (n = 54) and healthy controls (HC; n = 53) completed semi‐structured diagnostic interviews, self‐report questionnaires, and 20 minutes of cardiorespiratory exercise at 60‐80% of estimated maximum heart rate (HR) on a bicycle ergometer. Average power (watts/kg) within this HR range served as a previously validated proxy for CRF. Brain magnetic resonance imaging (MRI) structural analysis was done using FreeSurfer. Analyses controlled for age and sex.
Results
CRF was significantly lower in BD vs HC (0.91 ± 0.32 vs 1.01 ± 0.30, p = 0.03, F = 4.66, df=1, η2=0.04). Within BD, greater depression symptoms were associated with lower CRF (P = .02), and greater physical activity (PA) was associated with greater CRF (P < .001). In multivariable analyses, there were significant main effects of diagnosis (HC>BD; P = .03) and sex (M > F; P < .001) on power. Significant predictors of power within BD included male sex (P = .02) and PA (P = .002) but not depression symptoms (P = .29). Significant diagnosis by CRF interaction effects was found in frontal, parietal, and occipital cortical regions.
Conclusion
CRF was reduced among adolescents with BD, particularly women, related in part to depression symptoms and inactivity and was differentially associated with regional brain structure. Studies seeking to improve CRF as a means of reducing psychiatric symptoms of BD are warranted.</description><subject>adolescent</subject><subject>Adolescents</subject><subject>Bipolar disorder</subject><subject>Cardiorespiratory fitness</subject><subject>Cardiovascular diseases</subject><subject>Diagnosis</subject><subject>Functional anatomy</subject><subject>Heart rate</subject><subject>Mental depression</subject><subject>Neuroimaging</subject><subject>Physical activity</subject><subject>Physical fitness</subject><subject>Risk factors</subject><subject>Sex</subject><subject>Structure-function relationships</subject><subject>Teenagers</subject><issn>1398-5647</issn><issn>1399-5618</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kD9PwzAQxS0EEqUw8A0sMTGktePYiUco_ypVYoHZcuxzcRXiYKdC_faYhpVb7g2_d6f3ELqmZEHzLFvrF7SUkp2gGWVSFlzQ5vSom6yr-hxdpLQjhIqS8Blyq8733ugO697iHvYx-E-99f0WmxAjdHqEhIPDRkfrQ4Q0-KjHEA_Y-bGHlLDvsbahg2SgHxP-9uMHbv0QOh2x9SlEC_ESnTndJbj623P0_vT4tnopNq_P69XdpjCMEVY4QV0lTKVZY40Dail32lYtaQS4Uoqm5oaTltfUOicpNKJtrXVMQw4EtWZzdDPdHWL42kMa1S7sY59fqpKzqpFcCJmp24kyMaQUwakh5tTxoChRvzWqXKM61pjZ5cR--w4O_4Pq_mE9OX4A1N122g</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Popel, Najla</creator><creator>Kennedy, Kody G.</creator><creator>Fiksenbaum, Lisa</creator><creator>Mitchell, Rachel H. B.</creator><creator>MacIntosh, Bradley J.</creator><creator>Goldstein, Benjamin I.</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><orcidid>https://orcid.org/0000-0003-0340-349X</orcidid><orcidid>https://orcid.org/0000-0002-6361-0469</orcidid><orcidid>https://orcid.org/0000-0003-2215-1224</orcidid></search><sort><creationdate>202105</creationdate><title>Clinical and neuroimaging correlates of cardiorespiratory fitness in adolescents with bipolar disorder</title><author>Popel, Najla ; Kennedy, Kody G. ; Fiksenbaum, Lisa ; Mitchell, Rachel H. B. ; MacIntosh, Bradley J. ; Goldstein, Benjamin I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3303-f61f46c4a38dcfe1d15fad4b086ef296875c50b571dff91e86bbddf3ae001e7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>adolescent</topic><topic>Adolescents</topic><topic>Bipolar disorder</topic><topic>Cardiorespiratory fitness</topic><topic>Cardiovascular diseases</topic><topic>Diagnosis</topic><topic>Functional anatomy</topic><topic>Heart rate</topic><topic>Mental depression</topic><topic>Neuroimaging</topic><topic>Physical activity</topic><topic>Physical fitness</topic><topic>Risk factors</topic><topic>Sex</topic><topic>Structure-function relationships</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Popel, Najla</creatorcontrib><creatorcontrib>Kennedy, Kody G.</creatorcontrib><creatorcontrib>Fiksenbaum, Lisa</creatorcontrib><creatorcontrib>Mitchell, Rachel H. B.</creatorcontrib><creatorcontrib>MacIntosh, Bradley J.</creatorcontrib><creatorcontrib>Goldstein, Benjamin I.</creatorcontrib><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><jtitle>Bipolar disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Popel, Najla</au><au>Kennedy, Kody G.</au><au>Fiksenbaum, Lisa</au><au>Mitchell, Rachel H. B.</au><au>MacIntosh, Bradley J.</au><au>Goldstein, Benjamin I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and neuroimaging correlates of cardiorespiratory fitness in adolescents with bipolar disorder</atitle><jtitle>Bipolar disorders</jtitle><date>2021-05</date><risdate>2021</risdate><volume>23</volume><issue>3</issue><spage>274</spage><epage>283</epage><pages>274-283</pages><issn>1398-5647</issn><eissn>1399-5618</eissn><abstract>Introduction
Cardiovascular disease (CVD) is exceedingly prevalent, and occurs prematurely in individuals with bipolar disorder (BD). Cardiorespiratory fitness (CRF), arguably the most important modifiable CVD risk factor, is also associated with brain structure and function. There is a gap in knowledge regarding CRF in BD, particularly in relation to brain structure.
Methods
Adolescents with BD (n = 54) and healthy controls (HC; n = 53) completed semi‐structured diagnostic interviews, self‐report questionnaires, and 20 minutes of cardiorespiratory exercise at 60‐80% of estimated maximum heart rate (HR) on a bicycle ergometer. Average power (watts/kg) within this HR range served as a previously validated proxy for CRF. Brain magnetic resonance imaging (MRI) structural analysis was done using FreeSurfer. Analyses controlled for age and sex.
Results
CRF was significantly lower in BD vs HC (0.91 ± 0.32 vs 1.01 ± 0.30, p = 0.03, F = 4.66, df=1, η2=0.04). Within BD, greater depression symptoms were associated with lower CRF (P = .02), and greater physical activity (PA) was associated with greater CRF (P < .001). In multivariable analyses, there were significant main effects of diagnosis (HC>BD; P = .03) and sex (M > F; P < .001) on power. Significant predictors of power within BD included male sex (P = .02) and PA (P = .002) but not depression symptoms (P = .29). Significant diagnosis by CRF interaction effects was found in frontal, parietal, and occipital cortical regions.
Conclusion
CRF was reduced among adolescents with BD, particularly women, related in part to depression symptoms and inactivity and was differentially associated with regional brain structure. Studies seeking to improve CRF as a means of reducing psychiatric symptoms of BD are warranted.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/bdi.12993</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0340-349X</orcidid><orcidid>https://orcid.org/0000-0002-6361-0469</orcidid><orcidid>https://orcid.org/0000-0003-2215-1224</orcidid></addata></record> |
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| subjects | adolescent Adolescents Bipolar disorder Cardiorespiratory fitness Cardiovascular diseases Diagnosis Functional anatomy Heart rate Mental depression Neuroimaging Physical activity Physical fitness Risk factors Sex Structure-function relationships Teenagers |
| title | Clinical and neuroimaging correlates of cardiorespiratory fitness in adolescents with bipolar disorder |
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