Cognition, Brain Structure, and Brain Function in Individuals with Obesity and Related Disorders

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ETIOLOGY OF OBESITY (M ROSENBAUM, SECTION EDITOR)

Cognition, Brain Structure, and Brain Function in Individuals with Obesity and Related Disorders Hirofumi Tanaka 1

&

Drew D. Gourley 1 & Maria Dekhtyar 2 & Andreana P. Haley 2,3

Accepted: 5 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Purpose of Review Obesity is one of the most serious public health concerns. Excess adipose tissue, particularly with a centralized distribution, is associated with cognitive decline. Indeed, obesity has been associated with a number of adverse changes in brain function and structure that can be detected by neuroimaging techniques. These obesity-associated changes in the brain are associated with cognitive dysfunction. Recent Findings While the pathways by which excess adipose tissue affects brain function are not fully understood, available evidence points towards insulin resistance, inflammation, and vascular dysfunction, as possible mechanisms responsible for the observed relations between obesity and cognitive impairment. Summary It appears that weight loss is related to better brain and cognitive outcomes and that cognitive impairment due to obesity may be reversible. Keywords Neuroimaging . Metabolic syndrome . Overweight . Aging . Midlife

Introduction Humans possess the remarkable capacity to store energy in the form of body fat when the opportunity to consume extra energy arises. From an evolutionary perspective, the storage of sufficient energy is essential for prevention of starvation and to protect reproductive integrity [1]. Obesogenic environments, characterized by abundant calorie dense foods and sedentary lifestyles, have contributed to the rising levels of obesity worldwide. Obesity constitutes a major public health threat because of deleterious effects on multiple tissues and organs [2, 3]. Obesity is closely associated with diabetes, metabolic syndrome (MetS), and cardiovascular diseases [3].

More recently identified consequences of obesity are cognitive deficits [4]. Neuroimaging studies have contributed to revealing morphological and neurophysiological changes in obesity and related disorders such as MetS [4]. The current review summarizes research evidence associating obesity and related disorders with cognitive function, brain structure, and brain neurophysiology (Fig. 1). Because obesity is a central feature of MetS and research on MetS is a logical extension of studies of obesity, the topic of MetS is highlighted. A primary focus is placed on middle-aged adults as neuropathological changes are known to precede the onset of clinically significant cognitive impairment and the relationships between obesity cognitive dysfunction appear nonlinear and most robust in midlife [5].

This article is part of the Topical Collection on Etiology of Obesity * Hirofumi Tanaka [email protected] 1

Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX 78712, USA

2

Department of Psychology, The Unive