Impact of Sleeve Gastrectomy on Brain Structural Integrity

Area of Science:

• Neuroimaging
• Bariatric Surgery Outcomes
• Obesity Research

Background:

• Investigating brain structural differences in people with obesity (PwO) based on excess weight loss (EWL) after sleeve gastrectomy (SG).
• Comparing gray matter volume (GMV) and white matter (WM) integrity in PwO with >50% EWL, <50% EWL, and controls with obesity (CwO) without prior bariatric surgery.

Purpose of the Study:

• To identify potential brain structural differences in PwO achieving varying levels of EWL post-SG.
• To compare GMV and WM integrity between successful and less successful weight loss groups and controls.

Main Methods:

• 1.5T MRI scans on 62 PwO (24 >50% EWL, 18 <50% EWL) and 20 CwO.
• Voxel-based morphometry and tract-based spatial statistics for GMV and WM analysis.
• Multiple regression to correlate structural and psychological measures.

Main Results:

• Group with >50% EWL had significantly lower GMV loss and higher WM integrity compared to other groups.
• Positive correlations in the >50% EWL group between WM integrity and psychological measures (lower integrity linked to higher distress, emotional dysregulation, binge eating).

Conclusions:

• Limited GMV changes but extensive WM microstructural differences observed between PwO with high vs. low EWL after SG.
• WM microstructural differences may indicate higher vulnerability of white matter to metabolic dysfunction in PwO.