Amit M Saindane1, Daniel L Drane2, Arvinpal Singh3, Junjie Wu4, Deqiang Qiu4. 1. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. Electronic address: asainda@emory.edu. 2. Departments of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Department of Neurology, University of Washington School of Medicine, Seattle, Washington. 3. Departments of Medicine and Surgery, Emory University School of Medicine, Atlanta, Georgia. 4. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Abstract
BACKGROUND: Obesity has been associated with cognitive deficits and increased risk for developing dementia. Bariatric surgery may result in improved cognitive function; however, the underlying structural and functional brain correlates are unclear. OBJECTIVES: This longitudinal study explores the hypothesis that specific brain regions and networks underlie cognitive changes after bariatric surgery. SETTING: University Hospital, United States. METHODS: Seventeen patients were recruited for this prospective cohort study, including 9 patients undergoing bariatric surgery, and 8 age-, sex-, and education level-matched healthy, nonobese control patients. Bariatric patients underwent longitudinal neuropsychologic tests and magnetic resonance imaging (MRI) scans both before and 6 months after surgery. One patient was lost to follow-up. The same neuropsychologic tests and MRI scans were performed for control patients. Differences in MRI and neuropsychologic testing between bariatric patients and control patients, and longitudinal changes within bariatric patients were assessed. RESULTS: At baseline, bariatric patients demonstrated deficits in cognitive function relative to control patients, including pattern comparison (P = .009) and picture sequence memory (P = .004), which improved after significant weight loss. Baseline cognitive deficits in bariatric patients were accompanied by significantly lower left executive control network connectivity on resting-state functional MRI relative to control patients (P = .028), but differences resolved or diminished after bariatric surgery. Longitudinal improvements in pattern comparison performance correlated significantly with increases in left executive control network connectivity (r = .819; P = .013). No significant group or longitudinal differences were found in brain perfusion or brain white matter lesions. CONCLUSIONS: Individuals with obesity undergoing bariatric surgery exhibit deficits in cognitive function and specific alterations of brain networks; however, cognitive performance can improve, and executive control network connectivity can increase after weight loss from bariatric surgery.
BACKGROUND:Obesity has been associated with cognitive deficits and increased risk for developing dementia. Bariatric surgery may result in improved cognitive function; however, the underlying structural and functional brain correlates are unclear. OBJECTIVES: This longitudinal study explores the hypothesis that specific brain regions and networks underlie cognitive changes after bariatric surgery. SETTING: University Hospital, United States. METHODS: Seventeen patients were recruited for this prospective cohort study, including 9 patients undergoing bariatric surgery, and 8 age-, sex-, and education level-matched healthy, nonobese control patients. Bariatric patients underwent longitudinal neuropsychologic tests and magnetic resonance imaging (MRI) scans both before and 6 months after surgery. One patient was lost to follow-up. The same neuropsychologic tests and MRI scans were performed for control patients. Differences in MRI and neuropsychologic testing between bariatric patients and control patients, and longitudinal changes within bariatric patients were assessed. RESULTS: At baseline, bariatric patients demonstrated deficits in cognitive function relative to control patients, including pattern comparison (P = .009) and picture sequence memory (P = .004), which improved after significant weight loss. Baseline cognitive deficits in bariatric patients were accompanied by significantly lower left executive control network connectivity on resting-state functional MRI relative to control patients (P = .028), but differences resolved or diminished after bariatric surgery. Longitudinal improvements in pattern comparison performance correlated significantly with increases in left executive control network connectivity (r = .819; P = .013). No significant group or longitudinal differences were found in brain perfusion or brain white matter lesions. CONCLUSIONS: Individuals with obesity undergoing bariatric surgery exhibit deficits in cognitive function and specific alterations of brain networks; however, cognitive performance can improve, and executive control network connectivity can increase after weight loss from bariatric surgery.
Authors: Kristina E Almby; Martin H Lundqvist; Niclas Abrahamsson; Sofia Kvernby; Markus Fahlström; Maria J Pereira; Malin Gingnell; F Anders Karlsson; Giovanni Fanni; Magnus Sundbom; Urban Wiklund; Sven Haller; Mark Lubberink; Johan Wikström; Jan W Eriksson Journal: Diabetes Date: 2021-03-04 Impact factor: 9.461