Long-Term Brain Structure and Cognition Following Bariatric Surgery

Area of Science:

• Neuroscience
• Bariatric Surgery
• Obesity Research

Background:

• Bariatric surgery (BS) leads to weight loss, impacting cognition and brain structure.
• Previous studies had small cohorts and short follow-up, limiting understanding of long-term neurological effects.

Purpose of the Study:

• To investigate the long-term effects of weight loss after BS on cognition, brain structure, and perfusion.
• To assess changes in cognitive performance, brain volumes, cortical thickness, and cerebral blood flow up to two years post-surgery.

Main Methods:

• A cohort study involving 133 participants with severe obesity undergoing Roux-en-Y gastric bypass.
• Data collected pre-surgery and at 6 and 24 months, including cognitive tests, brain imaging, and health markers.
• Analysis focused on changes in cognitive function, brain structure, cerebral blood flow, and general health indicators.

Main Results:

• Global cognition improved by at least 20% in 42.9% of participants at 24 months post-BS.
• Significant reductions in inflammatory markers, antihypertensive medication use, and depressive symptoms were observed.
• While most brain regions showed decreased structure and perfusion, the hippocampus and white matter remained stable; temporal cortex thickness increased, and its spatial coefficient of variation decreased.

Conclusions:

• Bariatric surgery is associated with significant cognitive and general health improvements two years after the procedure.
• The surgery positively impacts brain blood vessel efficiency and temporal cortex structure.
• These findings suggest BS could be a valuable treatment option for individuals with obesity, potentially mitigating risks associated with dementia.