Laparoscopic sleeve gastrectomy induces simultaneous changes in brain functions and structures that are associated with weight loss

Abstract

Introduction Laparoscopic sleeve gastrectomy (LSG) is one of the most effective interventions to promote weight-loss and induce reversal of brain functional and structural abnormalities. However, it is unclear whether these brain alterations occur simultaneously as well as the relationship with weight-loss.Methods We employed magnetic resonance imaging to investigate brain changes in 35 patients with obesity (OB), 36 normal-weight (NW) individuals, and 22 OB who received LSG and were studied at baseline and 1 month after LSG.Results Comparisons between OB and NW and between pre- and post-LSG showed (1) Resting-state activity differences in amplitude of low frequency fluctuation (ALFF) in the orbitofrontal cortex (OFC), caudate, hippocampus (HIPP), amygdala, thalamus, anterior cingulate cortex (ACC), and dorsolateral prefrontal cortex. (2) Structural differences in fractional anisotropy (FA) in the middle cerebellar peduncle (MCP), genu corpus collosum (GCC), cingulate (Cin), and superior longitudinal fasciculus. Correlation analysis showed that (1) Reduced BMI/waist-circumference was positively correlated with decreased ALFF in the OFC and negatively associated with increased FA in the GCC following LSG. (2) Increased ALFF in the ACC was positively correlated with increased FA in the GCC and MCP. ALFF in the HIPP was negatively correlated with FA in the Cin at post-LSG.Conclusions These findings provide evidence that LSG induces simultaneous changes in brain function and structure which are associated with weight-loss.