Bariatric Surgery and Brain Health—A Longitudinal Observational Study Investigating the Effect of Surgery on Cognitive Function and Gray Matter Volume

Abstract

Dietary modifications leading to weight loss have been suggested as a means to improve brain health. In morbid obesity, bariatric surgery (BARS)—including different procedures, such as vertical sleeve gastrectomy (VSG), gastric banding (GB), or Roux-en-Y gastric bypass (RYGB) surgery—is performed to induce rapid weight loss. Combining reduced food intake and malabsorption of nutrients, RYGB might be most effective, but requires life-long follow-up treatment. Here, we tested 40 patients before and six months after surgery (BARS group) using a neuropsychological test battery and compared them with a waiting list control group. Subsamples of both groups underwent structural MRI and were examined for differences between surgical procedures. No substantial differences between BARS and control group emerged with regard to cognition. However, larger gray matter volume in fronto-temporal brain areas accompanied by smaller volume in the ventral striatum was seen in the BARS group compared to controls. RYGB patients compared to patients with restrictive treatment alone (VSG/GB) had higher weight loss, but did not benefit more in cognitive outcomes. In sum, the data of our study suggest that BARS might lead to brain structure reorganization at long-term follow-up, while the type of surgical procedure does not differentially modulate cognitive performance.

Weight loss reduces head motion: Revisiting a major confound in neuroimaging

“…From the total study sample, we included all patients who received a MRI (for more details see (Prehn et al, )). We compared 33 obese participants who underwent bariatric surgery (scanned at baseline n = 21, no baseline BMI information for one participant, 7m/26f, aged 43.0 ± 11.9 years, BMI: 46.4 ± 5.9 kg/m 2 (mean ± SD )) to 17 obese participants in a waiting list‐control (scanned at baseline n = 16, 6 m/11f, aged: 47.5 ± 10.9 years, BMI 43.7 ± 5.2 kg/m 2 ).…”

Effects of bariatric surgery on functional connectivity of the reward and default mode network: A pre‐registered analysis

“…The ADIPOSITAS‐study investigated the effects of bariatric surgery on brain structure and function in a prospective design at the Charité University Medicine Berlin, Germany. For more details, see Prehn et al (2020). We used all data acquired until April 2019.…”

Effects of bariatric surgery on functional connectivity of the reward and default mode network: a pre-registered analysis

“…The ADIPOSITAS-Study investigated the effects of bariatric surgery on brain structure and function in a prospective design at the Charité University Medicine Berlin, Germany. For more details see (Prehn et al, 2020). We used all data acquired until April 2019.…”

“…They underwent medical assessments including an interview, blood draw and anthropometric measurements before having a one hour break for breakfast. MRI scanning was done after performing a psychological test battery (for details see Prehn et al, 2020).…”

“…MRI was performed with a 12-channel head coil on a 3 Tesla Trio, Siemens (Erlangen) with syngo B17 software. T1-weighted anatomical images were acquired as described in Prehn et al, 2020 (with MPRAGE, repetition time (TR) = 1900 ms, echo time (TE) = 2.52 ms, flip angle = 9°, voxel size= 1 × 1 × 1 mm 3 , 192 sagital slices). Resting-state echo-planar imaging was acquired with a TR of 2.3 s and TE of 30 ms.…”