The Association Between Reduced Inflammation and Cognitive Gains After Bariatric Surgery

Abstract

Objective Bariatric surgery is associated with improved cognitive function, though the mechanisms are unclear. Elevated inflammation is common in obesity and associated with impaired cognition. Inflammation decreases after bariatric surgery, implicating it as a possible mechanism for cognitive improvement. The objective of this study was to examine whether reduced inflammation is a possible mechanism for post-operative cognitive improvement in bariatric surgery patients. Methods Participants were 77 bariatric surgery patients who completed cognitive testing before surgery and one year post-surgery. Cognitive domains assessed were attention/executive function, language, and memory. High-sensitivity C-reactive protein (hs-CRP) was assessed at both time points. Results Patients exhibited pre-operative cognitive impairment, though attention/executive (M±SDbaseline= 53.57 ± 8.68 vs.M±SDfollow-up= 60.32 ± 8.19) and memory (M±SDbaseline= 44.96 ± 7.98 vs.M±SDfollow-up= 51.55 ± 8.25) improved one year post-surgery. CRP was elevated at baseline and fell into the normative range post-surgery (M±SDbaseline= 0.9 ± 0.7vs.M±SDfollow-up= 0.2 ± 0.3 mg/dL). Pre-operative CRP was not associated with baseline cognitive function (β-values = -0.10 to 0.02) and changes in CRP also did not correspond to changes in cognition post-surgery (β-values = 0.02 to β = 0.11; ps>0.05 for all domains). A trend was detected for smaller improvements in memory among participants with elevated baseline CRP (>0.30 mg/dL) versus those with normal levels (Group x Time: p=0.083). Conclusions Improvements in hs-CRP were not associated with post-operative cognitive benefits. Future studies are needed to explore other inflammatory markers and potential mechanisms of cognitive improvement after bariatric surgery, including improved glycemic control and neurohormone changes.

Neurocognitive Effects of Obesity and Bariatric Surgery

“…We tested the assumption that reductions in inflammation would predict improvements in post‐operative cognitive function using high‐sensitivity C‐reactive protein (hs‐CRP) as a marker of systemic inflammation. While reduced inflammation (as measured by hs‐CRP) did not predict improved cognitive function, these null findings do not rule out inflammation as a potential mechanism given that other candidate markers with potential to exert stronger neurocognitive effects (e.g., interleukin‐6) have yet to be tested (Hawkins et al, ).…”

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

“…Although we noted improvements after BARS in several physical parameters, indicating improvements in cardiovascular risk factors (e.g., decreases in total weight, systolic and diastolic blood pressure, and improvements in glucose metabolism and inflammation), we were not able to link these changes to the improvements in executive functions (cf. References [23,55]).…”

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