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Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact.
We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations.
BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI.
We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.
As British efforts to secure the approaches to India intensified in the closing years of the nineteenth century, expert knowledge of the states bordering the subcontinent became an increasingly sought-after commodity. Particularly high demand existed for individuals possessing first-hand experience of Qajar Persia, a state viewed by many policymakers as a vulnerable anteroom on the glacis of the Raj. Britain's two foremost Persian experts during this period were George Nathaniel Curzon and Edward Granville Browne. While Curzon epitomized the traditional gentleman amateur, Browne embodied the emerging professional scholar. Drawing on both their private papers and publications, this article analyses the relationship between these two men as well as surveys their respective views of British policy toward Iran from the late 1880s until the end of the First World War. Ultimately it contends that Curzon's knowledge of Persia proved deficient in significant ways and that Anglo-Iranian relations, at least in the aftermath of the Great War, might well have been placed on a better footing had Browne's more nuanced understanding of the country and its inhabitants prevailed within the foreign policymaking establishment.
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