Bariatric surgery associated with improved general health and cognition: JAMA

A recent study published in the Journal of American Medical Association explored the long-term neurological outcomes associated with bariatric surgery (BS). The study from Rijnstate Hospital in Arnhem, Netherlands and Radboudumc Neuroimaging and Cognition in Obesity focused on the participants with severe obesity who were eligible for Roux-en-Y gastric bypass.

This study followed a total of 133 participants aged 35 to 55 years over the period from September 2018 to March 2023. Emma Custers and team collected data before BS and at 6 and 24 months post-surgery. The primary outcomes included various parameters such as body weight, cognitive performance, brain volumes, cortical thickness and cerebral blood flow.

The results from two years post-BS found over 40% of participants experience a significant improvement in global cognition. The inflammatory markers decreased substantially, while the use of antihypertensive medications dropped by more than half. The participants also reported lower depressive symptoms and higher levels of physical activity. One of the major finding was the impact of BS on brain structure and perfusion. While most brain regions expressed lower perfusion post-surgery, the hippocampal and white matter volume remained stable.

The temporal cortex showed increased thickness and improved blood vessel efficiency that suggests a positive impact on cognitive function. These outcomes may improve treatment options for patients with obesity and dementia. This study provides long-term data on the neurological benefits of BS. These findings offer hope for patients and healthcare professionals as obesity rates and its association with cognitive decline are becoming increasingly evident.

Reference:

Custers, E., Vreeken, D., Kleemann, R., Kessels, R. P. C., Duering, M., Brouwer, J., Aufenacker, T. J., Witteman, B. P. L., Snabel, J., Gart, E., Mutsaerts, H. J. M. M., Wiesmann, M., Hazebroek, E. J., & Kiliaan, A. J. (2024). Long-Term Brain Structure and Cognition Following Bariatric Surgery. In JAMA Network Open (Vol. 7, Issue 2, p. e2355380). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.55380