Email updates

Keep up to date with the latest news and content from BMC Obesity and BioMed Central.

Open Access Research article

Higher BMI is associated with reduced brain volume in heart failure

Michael L Alosco1*, Adam M Brickman2, Mary Beth Spitznagel13, Atul Narkhede2, Erica Y Griffith2, Naftali Raz4, Ronald Cohen5, Lawrence H Sweet6, Lisa H Colbert7, Richard Josephson1089, Joel Hughes13, Jim Rosneck3 and John Gunstad13

Author Affiliations

1 Department of Psychology, Kent State University, Kent, OH, USA

2 Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA

3 Department of Psychiatry, Summa Health System, Akron City Hospital, Akron, OH, USA

4 Institute of Gerontology, Wayne State University, Detroit, MI, USA

5 Departments of Neurology Psychiatry and the Institute on Aging, Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL 32611, USA

6 Department of Psychology, University of Georgia, Athens, GA, USA

7 Department of Kinesiology, University of Wisconsin, Madison, WI, USA

8 Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

9 Harrington Heart & Vascular Institute, Cleveland, OH, USA

10 Case Western Reserve University School of Medicine, Cleveland, OH, USA

For all author emails, please log on.

BMC Obesity 2014, 1:4  doi:10.1186/2052-9538-1-4

Published: 19 February 2014



Heart failure (HF) patients are at risk for structural brain changes due to cerebral hypoperfusion. Past work shows obesity is linked with reduced cerebral blood flow and associated with brain atrophy in healthy individuals, although its effects on the brain in HF are unclear. This study examined the association among body mass index (BMI), cerebral perfusion, and brain volume in HF patients.


Eighty HF patients underwent transcranial Doppler sonography to quantify cerebral blood flow velocity of the middle cerebral artery (CBF-V of the MCA) and brain magnetic resonance imaging (MRI) to quantify total brain, total and subcortical gray matter, white matter volume, and white matter hyperintensities. Body mass index (BMI) operationalized weight status. Nearly 45% of HF patients exhibited a BMI consistent with obesity. Regression analyses adjusting for medical variables, demographic characteristics, and CBF-V of the MCA, showed increased BMI was associated with reduced white matter volume (p < .05). BMI also interacted with cerebral perfusion to impact total gray matter volume, but this pattern did not emerge for any other MRI indices (p < 0.05).


Our findings suggest increased BMI negatively affects brain volume in HF, and higher BMI interacts with cerebral perfusion to impact gray matter volume. The mechanisms for these findings remain unclear and likely involve multiple physiological processes. Prospective studies are needed to elucidate the exact pattern and rates of brain changes in obese HF persons.

Brain volume; Cerebral blood flow; Heart failure; Neuroimaging; Obesity