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ORIGINAL RESEARCH article

Front. Neurosci.
Sec. Translational Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1454284
This article is part of the Research Topic Central Nervous System Diseases and Anesthesia View all 6 articles

Distinct Brain and Neurocognitive Transformations after Bariatric Surgery: a Pilot Study

Provisionally accepted
Bhaswati Roy Bhaswati Roy 1Mariana Thedim Mariana Thedim 2Chiewlin Liew Chiewlin Liew 1Rajesh Kumar Rajesh Kumar 1Susana Vacas Susana Vacas 2*
  • 1 University of California, Los Angeles, Los Angeles, California, United States
  • 2 Massachusetts General Hospital, Harvard Medical School, Boston, United States

The final, formatted version of the article will be published soon.

    Background: Obese patients have worse outcomes after surgery and are at increased risk for perioperative neurocognitive disorders (PND). Our aim was to detail the cognitive trajectories of patients undergoing bariatric surgery (BS) and map distinct structural brain changes using magnetic resonance imaging (MRI) to better understand the association between the vulnerable brain, surgery, and the arc of PND. Methods: Prospective pilot study with longitudinal comprehensive cognitive assessments and MRI were performed on obese patients scheduled for BS. We analyzed baseline cognitive function and high-resolution T1-/T2-weighted brain images on 19 obese patients (age, 54 (9) years, BMI, 40 (36, 42)) and compared with 50 healthy control subjects (age, 52 (6) years; BMI, 25 (24, 27)).Patients were evaluated within five days of BS (baseline), immediately after (within 48h), and follow up at six months. Results: At baseline, obese patients had significant brain tissue changes seen in MRI and decreased cognitive scores compared to controls (MoCA 26 vs 28, P = 0.017). Surgery induced further gray matter volume and brain tissue changes along with reduced cognitive scores within the immediate postoperative period (MoCA 26 vs 24, P < 0.001). At six months, we observed reversal of brain alterations for most patients and a concomitant rebound of cognitive scores to patient's baseline status.Conclusions: Bariatric surgery resulted in worsening of preexisting brain structural integrity and lower cognitive function for obese patients compared to baseline. These distinct brain lesions are consistent with specific domains of cognition. Most of these changes reverted to patient's baseline condition within six months after surgery.

    Keywords: Bariatric Surgery, cognitive dysfunction, Magnetic Resonance Imaging, Neuropsychological Tests, Obesity, Perioperative neurocognitive disorders, Surgery

    Received: 24 Jun 2024; Accepted: 16 Oct 2024.

    Copyright: © 2024 Roy, Thedim, Liew, Kumar and Vacas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Susana Vacas, Massachusetts General Hospital, Harvard Medical School, Boston, United States

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