Changes in Cognitive Function Following Bariatric Surgery: a Systematic Review

Handley, Joel; Williams, David M.; Caplin, Scott; Stephens, Jeffrey W.; Barry, Jonathan

doi:10.1007/s11695-016-2312-z

Cited by 72 publications

(56 citation statements)

References 68 publications

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“…In the present study, we did not find any substantial improvement in cognitive functions (primary and secondary outcomes) in patients of the BARS as compared to the NBARS group. This result was surprising in light of previous studies demonstrating the beneficial effects of weight loss after BARS on cognitive performance [19,20]. The only indication that BARS might have a beneficial Surgery groups, however, did not differ substantially with regard to changes in cognitive functions, mood/affect, and health-related quality of life.…”

Section: Effects Of Bars On Cognitive Functionscontrasting

confidence: 63%

“…In addition to weight loss and recovery from obesity-related diseases, a number of studies showed improved cognitive function after BARS (e.g., References [13][14][15][16]). Although most studies documented improvement in at least one neurocognitive domain, such as executive functions, memory, or attention, they were not unequivocal and consistent (for reviews, see References [17][18][19][20]). Georgiadou et al [21], for instance, was unable to find any substantial differences in cognitive assessments comparing 50 post-RYGB patients to a well-matched sample of patients seeking BARS.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Effects Of Bars On Cognitive Functionscontrasting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…In this vein, Haltia et al (14) reported that cerebral white matter was more related to visceral fat accumulation, a marker of metabolic dysfunction, rather than total body fat mass. Together, these findings raise the possibility that changes in inflammation and metabolic factors following bariatric surgery improve WM structure and integrity, which may contribute, in part, to the improvement in cognitive functions observed after surgery-induced weight loss (26,27).…”

Section: Discussionmentioning

confidence: 93%

“…Bariatric surgery represents an interesting approach to address these questions, since it allows the examination of the effects of sustained weight loss and long-term metabolic improvements on the brain in a longitudinal setting (23)(24)(25). Growing evidence shows improvement in cognitive functions after bariatric surgery (26,27). However, only few structural MRI studies examined changes in GM and WM densities after bariatric surgery (9,28,29).…”

Section: Introductionmentioning

confidence: 99%

Neuroanatomical Changes in White and Grey Matter after Sleeve Gastrectomy

Michaud

Dadar

Pelletier

et al. 2019

Preprint

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Background: MRI studies show that obese adults have reduced grey (GM) and white matter (WM) tissue density as well as altered WM integrity. It remains to be examined if bariatric surgery induces structural brain changes. The aim of this study is to characterize GM and WM density changes in a longitudinal setting, comparing pre-and post-operation and to determine whether these changes are related to inflammation and cardiometabolic markers. Methods: 29 severely obese participants (age: 45.9±7.8 years) scheduled to undergo sleeve gastrectomy (SG) were recruited. High-resolution T1-weighted anatomical images were acquired 1 month prior to as well as 4 and 12 months after surgery. GM and WM densities were quantified using voxel-based morphometry (VBM). Circulating lipid profile, glucose, insulin and inflammatory markers (interleukin (IL)-6, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) were measured at each time point.A linear mixed effect model was used to compare brain changes before and after SG, controlling for age, gender, initial BMI and diabetic status. To assess the associations between changes in adiposity, metabolism and inflammation and changes in GM or WM density, the mean GM and WM densities were extracted across all the participants using atlas, and linear mixed-effect models were used. Results: As expected, weight, BMI, waist circumference and neck circumference significantly decreased after SG compared with baseline (p<0.001 for all). A widespread increase in WM density was observed after surgery, particularly in the cerebellum, brain stem, cerebellar peduncle, cingulum, corpus callosum and corona radiata (p<0.05, after FDR correction). Significant increases in GM density were observed 4 months after SG compared to baseline in several brain regions such as the bilateral occipital cortex, temporal cortex, precentral gyrus and cerebellum as Michaud et al. 2019, page 3 well as right fusiform gyrus, right hippocampus and right insula. These GM and WM increases were more pronounced and widespread after 12 months and were significantly associated with post-operative weight loss and the improvement of metabolic alterations.Our linear mixed-effect models also showed strong associations between post-operative reductions in LBP, a marker of inflammation, and increased WM density. To confirm our results, we tested whether the peak of each significant region showed BMI-related differences in an independent dataset (Human Connectome Project). We matched a group of severely obese individuals with a group of lean individuals for age, gender and ethnicity.Severe obesity was associated with reduced WM density in the brain stem and cerebellar peduncle as well as reduced GM density in cerebellum, regions that significantly changed after surgery (p<0.01 for all clusters). Conclusions: Bariatric surgery-induced weight loss and improvement in metabolic alterations is associated with widespread increases in WM and GM densities. These post-operative changes overlapped with baseline brain difference...

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“…Bariatric surgery has emerged as the most effective procedure to achieve rapid, significant and long-lasting weight reduction in individuals with moderate to extreme obesity (Maciejewski et al, 2016;O'Brien, MacDonald, Anderson, Brennan, & Brown, 2013;Padwal et al, 2011;Sjöström et al, 2004). Longitudinal studies have documented that weight loss induced by the surgery produces rapid and significant cognitive improvements (for reviews Handley, Williams, Caplin, Stephens, & Barry, 2016;Spitznagel et al, 2015;Veronese et al, 2017). Furthermore, improvements in executive functioning persist for at least 3 years after surgery .…”

Section: Introductionmentioning

confidence: 99%

Behavioral and electrophysiological correlates of cognitive control in ex-obese adults

Tarantino

Vindigni

Bassetto

et al. 2017

Biological Psychology

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Impaired cognitive control functions have been documented in obesity. It remains unclear whether these functions normalize after weight reduction. We compared ex-obese individuals, who successfully underwent substantial weight loss after bariatric surgery, to normal-weight participants on measures of resistance to interference, cognitive flexibility and response inhibition, obtained from the completion of two Stroop tasks, a Switching task and a Go/NoGo task, respectively. To elucidate the underlying brain mechanisms, event-related potentials (ERPs) in the latter two tasks were examined. As compared to controls, patients were more susceptible to the predominant but task-irrelevant stimulus dimension (i.e., they showed a larger verbal Stroop effect), and were slower in responding on trials requiring a task-set change rather than a task-set repetition (i.e., they showed a larger switch cost). The ERP correlates revealed altered anticipatory control mechanisms (switch positivity) and an exaggerated conflict monitoring response (N2). The results suggest that cognitive control is critical even in ex-obese individuals and should be monitored to promote weight loss maintenance.

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Changes in Cognitive Function Following Bariatric Surgery: a Systematic Review

Cited by 72 publications

References 68 publications

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

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

Neuroanatomical Changes in White and Grey Matter after Sleeve Gastrectomy

Behavioral and electrophysiological correlates of cognitive control in ex-obese adults

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