Long-Term Brain Structure and Cognition Following Bariatric Surgery

• DOI: 10.1001/jamanetworkopen.2023.55380
• Publication Date: 2024-02-09T16:32:20Z
• Authors: Emma Custers; Debby Vreeken; Robert Kleemann; Roy P. C. Kessels; Marco Duering; Jonna Brouwer; Theo J. Aufenacker; Bart P. L. Witteman; Jessica Snabel; Eveline Gart; Henk J. M. M. Mut...; Maximilian Wiesmann; Eric J. Hazebroek; Amanda J. Kiliaan
• Keywords: 03 medical and health sciences; Medical Imaging - Radboud University Medical Center - DCMN; Neuro- en revalidatiepsychologie; 0302 clinical medicine; Neuropsychology and rehabilitation psychology; Life Science; Original Investigation

Importance Weight loss induced by bariatric surgery (BS) is associated with improved cognition and changed brain structure; however, previous studies on the association have used small cohorts short follow-up periods, making it difficult to determine long-term neurological outcomes BS. Objective To investigate associations of weight after BS structure perfusion. Design, Setting, Participants This cohort study included participants from Bariatric Surgery Rijnstate Radboudumc Neuroimaging Cognition in Obesity study. Data severe obesity (body mass index [BMI; calculated as kilograms divided height meters squared] >40, or BMI >35 comorbidities) eligible for Roux-en-Y gastric bypass aged 35 55 years were enrolled a hospital specialized (Rijnstate Hospital, Arnhem, Netherlands). recruited between September 2018 December 2020 till March 2023. collected before at 6 24 months analyzed November Exposure bypass. Main Outcomes Measures Primary body weight, BMI, waist circumference, blood pressure, medication use, cognitive performance (20% change compound z -score), volumes, cortical thickness, cerebral flow (CBF), spatial coefficient variation (sCOV). Secondary include cytokines, adipokines, depressive symptoms (assessed using Beck Depression Inventory), physical activity Baecke Questionnaire). Results A total 133 (mean [SD] age, 46.8 [5.7] years; 112 [84.2%] female) included. Global was least 20% higher 52 (42.9%) Compared baseline, months, inflammatory markers lower high-sensitivity C-reactive protein: 4.77 [5.80] μg/mL vs 0.80 [1.09] μg/mL; P < .001), fewer patients antihypertensives (48 [36.1%] 22 [16.7%]), had (median [IQR] BDI score: 9.0 [5.0-13.0] 3.0 [1.0-6.0]; .001) greater 7.64 [1.29] 8.19 [1.35]; .001). After BS, perfusion most regions, while hippocampal white matter volume remained stable. CBF sCOV did not nucleus accumbens parietal cortex. The temporal cortex showed thickness thickness: 2.724 [0.101] mm 2.761 [0.007] mm; = .007) sCOV: 4.41% [3.83%-5.18%] 3.97% [3.71%-4.59%]; .02) Conclusions Relevance These findings suggest that health benefits 2 surgery. general vessel efficiency results may improve treatment options dementia.