A151 - An Unintended Consequence of Sleeve Gastrectomy: Portomesenteric Venous Thrombosis

Abstract

accessed, fluid removed, and immediately replaced with no net change. Patients and assessors were blinded to condition, and deflation/sham-deflation days were counterbalanced. On both days, patients completed a form indicating their estimate (deflation/ sham), followed by a food cue paradigm in the scanner where they viewed pictures of unhealthy, healthy, and shuffled food images. BOLD activation to unhealthy versus shuffled images was analyzed using SPM8. Contiguous clusters with kZ10 were deemed significant at po.005 corrected, determined by 10,000 MonteCarlo simulations (Cox, 1996). Results: In the deflate versus sham condition, patients showed significantly greater activation in thalamus, lingual gyrus, putamen (reward-related regions), superior and inferior frontal gyri, cingulate gyrus (inhibitory and emotional control), and parahippocampal gyrus (reward/ hunger/memory) to unhealthy food images versus shuffled images. Patients correctly identified the procedure as a deflation 66.7% of the time and as sham 75% of the time. Conclusions: Our findings are consistent in identifying brain regions found in other studies regarding obesity and food cues. Because band deflation increased responses in reward-related regions, band inflation may work at a neuronal level by controlling reward responses to food, making regulation of food intake and consequently, weight loss easier to achieve. The increased activation in regions associated with inhibitory and emotional control during band deflation suggests that patients may need to engage cognitive control regions to restrain their food choices. This could be due to the lack of physical gastric restriction and therefore fear of loss of control. This is the first study to demonstrate that deflation of LAGB leads to brain changes related to reward and emotional control.