A review of brain structural and functional changes using MRI technology in patients who received bariatric surgery.

Hugo Sandoval, Benjamin Clapp, Laura E O'Dell, Deborah J Clegg
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Abstract

According to the World Health Organization, obesity is one of the most significant health issues currently because it increases risk for type 2 diabetes and cancer, heart disease, bone health, reproduction, and quality of living and it impacts approximately 500 million adults worldwide. This review analyzed the existing literature focusing on the effects of Metabolic and bariatric surgeries (MBS), including Roux-en-Y gastric bypass and sleeve gastrectomy on changes in brain function and anatomy using magnetic resonance imaging (MRI) technology. A PubMed search using the key words bariatric surgery and MRI conducted in December 2023 resulted in 544 articles. Our literature review identified 24 studies addressing neuroanatomic, neurophysiological, cognitive, and behavioral changes that occurred at different time intervals after different types of bariatric surgery. Our review of the literature found several reports indicating that MBS reverse neuroanatomic alterations and changes in functional connectivity associated with obesity. There were also reported improvements in cognitive performance, memory, executive function, attention, as well as decreased gustatory brain responses to food cues and resting state measures following bariatric surgery. There were instances of improved neural functioning associated with weight loss, suggesting that some neuroanatomic changes can be reversed following weight loss induced by bariatric surgery. Additionally, there were data suggesting that brain connectivity and metabolic health are improved following a bariatric surgical intervention. Together, the existing literature indicates an overall improvement in brain connectivity and health outcomes following bariatric surgery.

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利用核磁共振成像技术回顾减肥手术患者的大脑结构和功能变化。
世界卫生组织指出,肥胖是当前最重要的健康问题之一,因为它会增加罹患 2 型糖尿病和癌症、心脏病、骨骼健康、生殖和生活质量的风险,影响着全球约 5 亿成年人。本综述利用磁共振成像(MRI)技术对现有文献进行了分析,重点研究代谢和减肥手术(MBS),包括Roux-en-Y胃旁路术和袖带胃切除术对大脑功能和解剖结构变化的影响。2023 年 12 月,我们在 PubMed 上以减肥手术和 MRI 为关键词进行了搜索,共搜索到 544 篇文章。我们的文献综述确定了 24 项研究,涉及不同类型减肥手术后在不同时间间隔内发生的神经解剖、神经生理学、认知和行为变化。我们的文献综述发现,有几篇报告指出,MBS 可逆转与肥胖相关的神经解剖改变和功能连接变化。还有报告称,减肥手术后,认知能力、记忆力、执行功能、注意力都有所改善,大脑对食物线索的味觉反应和静息状态测量也有所下降。有研究表明,神经功能的改善与体重减轻有关,这表明通过减肥手术减轻体重后,一些神经解剖学的变化是可以逆转的。此外,还有数据表明,在减肥手术干预后,大脑的连接性和新陈代谢健康状况会得到改善。总之,现有文献表明,减肥手术后大脑连通性和健康状况会得到全面改善。
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Comment on: endoscopic bariatric and metabolic therapies and its effect on MASLD: a review of the current literature. Comment on: The safety profile of one-anastomosis gastric bypass compared to Roux-en-Y gastric bypass: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program analysis. Letter to the editor regarding "Racial disparities in the utilization and outcomes of robotic bariatric surgery: an 8-year analysis of Metabolic and Bariatric Surgery Accreditation Quality Improvement Program data". Comment on: Patients' experience with preoperative use of anti-obesity medications and associations with bariatric surgery expectations. The trend of atherogenic indices in patients with type 2 diabetes after bariatric surgery: a national cohort study.
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