Body Mass Index Moderates Brain Dynamics and Executive Function: A Structural Equation Modeling Approach

Obesity is associated with negative physical and mental health outcomes. Being overweight/obese is also associated with executive functioning impairments and structural changes in the brain. However, the impact of body mass index (BMI) on the relationship between brain dynamics and executive function (EF) is unknown. The goal of the study was to assess the modulatory effects of BMI on brain dynamics and EF. A large sample of publicly available neuroimaging and neuropsychological assessment data collected from 253 adults (18–45 years; mean BMI 26.95 kg/m2 ± 5.90 SD) from the Nathan Kline Institute (NKI) were included (http://fcon_1000.projects.nitrc.org/indi/enhanced/). Participants underwent resting-state functional MRI and completed the Delis-Kaplan Executive Function System (D-KEFS) test battery (1). Time series were extracted from 400 brain nodes and used in a co-activation pattern (CAP) analysis. Dynamic CAP metrics including dwell time (DT), frequency of occurrence, and transitions were computed. Multiple measurement models were compared based on model fit with indicators from the D-KEFS assigned a priori (shifting, inhibition, and fluency). Multiple structural equation models were computed with interactions between BMI and the dynamic CAP metrics predicting the three latent factors of shifting, inhibition, and fluency while controlling for age, sex, and head motion. Models were assessed for the main effects of BMI and CAP metrics predicting the latent factors. A three-factor model (shifting, inhibition, and fluency) resulted in the best model fit. Significant interactions were present between BMI and CAP 2 (lateral frontoparietal (L-FPN), medial frontoparietal (M-FPN), and limbic nodes) and CAP 5 (dorsal frontoparietal (D-FPN), midcingulo-insular (M-CIN), somatosensory motor, and visual network nodes) DTs associated with shifting. A higher BMI was associated with a positive relationship between CAP DTs and shifting. Conversely, in average and low BMI participants, a negative relationship was seen between CAP DTs and shifting. Our findings indicate that BMI moderates the relationship between brain dynamics of networks important for cognitive control and shifting, an index of cognitive flexibility. Furthermore, higher BMI is linked with altered brain dynamic patterns associated with shifting.