Resting‐State Brain Connectivity Predicts Weight Loss and Cognitive Control of Eating Behavior After Vertical Sleeve Gastrectomy

Cerit, Hilâl; Davidson, Paul; Hye, Taryn; Moondra, Priyanka; Haimovici, Florina; Sogg, Stephanie; Shikora, Scott A.; Goldstein, Jill M.; Evins, A. Eden; Whitfield-Gabrieli, Susan; Stoeckel, Luke E.; Holsen, Laura M.

doi:10.1002/oby.22607

Cited by 26 publications

(40 citation statements)

References 39 publications

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“…Many neuroimaging findings in RYGB subjects were often associated with self-reported exaggerated fullness and lower levels of appetite with altered food preferences ( Ochner et al, 2011 ; Hunt et al, 2016 ; Zoon et al, 2018 ; Baboumian et al, 2019 ). Similar brain imaging observations made after VSG ( Cerit et al, 2019 ). Furthermore, widespread structural and functional changes across the brain also take place after RYGB ( Rullmann et al, 2018 ) and VSG ( Michaud et al, 2020 ).…”

Section: Potential Mechanisms Leading To Phantom Satiationsupporting

confidence: 78%

The Phantom Satiation Hypothesis of Bariatric Surgery

Gautron

2021

Front. Neurosci.

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The excitation of vagal mechanoreceptors located in the stomach wall directly contributes to satiation. Thus, a loss of gastric innervation would normally be expected to result in abrogated satiation, hyperphagia, and unwanted weight gain. While Roux-en-Y-gastric bypass (RYGB) inevitably results in gastric denervation, paradoxically, bypassed subjects continue to experience satiation. Inspired by the literature in neurology on phantom limbs, I propose a new hypothesis in which damage to the stomach innervation during RYGB, including its vagal supply, leads to large-scale maladaptive changes in viscerosensory nerves and connected brain circuits. As a result, satiation may continue to arise, sometimes at exaggerated levels, even in subjects with a denervated or truncated stomach. The same maladaptive changes may also contribute to dysautonomia, unexplained pain, and new emotional responses to eating. I further revisit the metabolic benefits of bariatric surgery, with an emphasis on RYGB, in the light of this phantom satiation hypothesis.

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Section: Potential Mechanisms Leading To Phantom Satiationsupporting

confidence: 78%

The Phantom Satiation Hypothesis of Bariatric Surgery

Gautron

2021

Front. Neurosci.

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“…Some metabolic markers may predict weight regain after surgery (Abidi et al, 2019), also taste preference towards salty or sucrose-sweetened foods may contribute to some extent (Zhang et al, 2019; Smith et al, 2020). Our study is the first PET study to predict the outcome of bariatric surgery from neuroimaging markers, and only two small MRI studies exist (Holsen et al, 2018; Cerit et al, 2019). Our study shows that molecular organization of the brain’s reward circuit is an important determinant of the surgery-induced weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there are only two small MRI studies that have investigated brain markers that might affect the weight loss outcome of the surgery. Functional connectivity and alterations in brain activity in some of the key areas of reward circuit predicted weight loss 12 months after sleeve gastrectomy (Holsen et al, 2018; Cerit et al, 2019). However, the role of specific neurotransmitter systems – such as D 2 R and MOR implicated in feeding and reward processing – on post-surgical weigh gain and loss remain unknown.…”

Section: Introductionmentioning

confidence: 99%

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

Karlsson

Tuominen

Helin

et al. 2021

Preprint

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BackgroundBariatric surgery is the most effective method for weight loss in morbid obesity. There is significant individual variability in the weight loss outcomes, yet factors leading to postoperative weight loss or weight regain remain elusive. Alterations in the µ-opioid receptor (MOR) and dopamine D2 receptor (D2R) systems are associated with obesity, appetite control, and reward processing. The magnitude of initial brain receptor system perturbation is a plausible predictor of long-term surgical weight loss outcomes. The aim was to test this hypothesis by measuring obese subjects’ MOR and D2R availability with positron emission tomography (PET) preoperatively before bariatric surgery and then assessing their weight development association with regional MOR and D2R availabilities at 2-year follow-up.MethodsWe studied 19 morbidly obese women (mean BMI 40, mean age 43) scheduled to undergo bariatric surgery, i.e. Roux-en-Y gastric bypass or sleeve gastrectomy, according to their standard clinical treatment. Preoperative MOR and D2R availabilities were measured using PET with [11C]carfentanil and [11C]raclopride, respectively. Subject weight was recorded at 3, 6, 12, and 24 months after surgery. Radiotracer binding potentials (BPND) were extracted and correlated with patient weight at different time points. ROIs were delineated in the striatum and in limbic and paralimbic components of the emotion and reward networks.ResultsMOR availabilities were not correlated with preoperative weight. MOR availabilities in the amygdala (r = −0.54), insula (r = −0.46), ventral striatum (r = −0.48) and putamen (r = −0.49) were associated with subject weight at 3 months. Significant association was found in the amygdala at 6 months (r = −0.53), 12 (r = −0.49), and 24 months (r = −0.50). D2R availabilities were associated with neither preoperative weight nor weight loss at any follow-up time point.ConclusionsTo our knowledge, this is the first study to demonstrate that neuroreceptor markers prior to bariatric surgery in patients with morbid obesity are associated with the postoperative weight loss. Preoperative MOR availability in the amygdala was associated with long-term postoperative weight development after surgery suggesting that postoperative weight regain may derive from dysfunction in the opioid system. Postoperative weight loss outcomes after bariatric surgery may be partially predicted based on preoperative receptor availability opening up new potential for treatment possibilities.Clinical Trials RegistrationSleevePET2, NCT01373892, http://www.clinicaltrials.gov

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“…It has also shown that NAc functional connectivity with frontoparietal-accumbal may have some role in dopaminergic and reward systems of the brain [ 44 ]. As a result, the functional connectivity of the frontoparietal network and the NAc may have a role as a predictor factor for the BMI at baseline and change over time [ 37 , 38 , 39 , 40 , 41 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although NAc function is a well-established predictor of food-seeking behaviors [ 21 ], less is known about the role of connectivity between the NAc and frontoparietal network on obesity [ 37 , 38 , 39 , 40 , 41 ]. While we know that NAc function is different in obesity-prone individuals than others [ 26 , 27 , 28 , 29 , 30 , 31 ], there is a need for longitudinal epidemiological studies on the NAc-frontoparietal connectivity as a predictor of obesity risk at the population level [ 21 ].…”

Section: Introductionmentioning

confidence: 99%