Authors:
Heßler, Sebastian Stefan
Abstract:
Abstract Background: Several studies showed improvement of cognitive performance additionally to weight loss after bariatric surgery. There are assumptions that recovery from comorbidities, improvements of blood composition and psychological state are positively influencing cognitive performance. The aim of this study was the investigation of correlations to clarify the causes. Methods: NeuroCure Clinical Research Center at Charité Berlin tested an obese intervention group (n=39) who underwent surgical intervention at three time points: Baseli (...)
Abstract Background: Several studies showed improvement of cognitive performance additionally to weight loss after bariatric surgery. There are assumptions that recovery from comorbidities, improvements of blood composition and psychological state are positively influencing cognitive performance. The aim of this study was the investigation of correlations to clarify the causes. Methods: NeuroCure Clinical Research Center at Charité Berlin tested an obese intervention group (n=39) who underwent surgical intervention at three time points: Baseline (shortly before surgical intervention), Follow up 1 (six months) and Follow up 2 (one year after surgery). Methods for surgical intervention were Roux-en-Y gastric bypass, Vertical sleeve gastrectomy and gastric banding. Parts of the investigation were physical examination, blood collection and neuropsychological testing. Patients were compared to an obese control group (n=23) without intervention which was tested in the same time intervals. We hypothesized improvement in the cognitive Domains “memory” and “executive functions” after surgery in comparison to obese controls. Data were statistically analyzed with an Analysis of covariances for comparison between groups and time points as well as with post-hoc t-tests for dependent samples. Furthermore, we investigated for correlations between physical and cognitive as well as psychological improvements between Baseline and Follow up 2. Results: The ANCOVA showed trends to significant improvement for Composite Scores of “executive functions” (p=,089) and in Stroop test (p=,067), with the greatest improvements of intervention group at Follow up 1. There was no improvement in the memory domain. But psychological state showed noticeable improvements, especially with regard to depression, anxiety and physical well-being. The comparison of surgical methods showed a group*time-interaction for verbal list learning, when Patients with RYGB worsened between Follow up 1 and Follow up 2. Anxiety was more reduced as well as physical well-being increased more between Baseline and Follow up 1 after restrictive procedure. There were no correlations between weight loss respectively physical improvements in blood markers and cognitive changes between Baseline and Follow-up 2 (all p values >,05). But there were correlations between reduction of inflammation markers interleukin-6 (r=-,597, p=,001) and tumor necrosis factor alpha (r=-,497, p=,006) as well as depression (r=-,378, p=,043) and improvement in physical well-being which also correlated with better Stroop test performance (r=,390, p=,037). Conclusion: Executive functions showed small improvement, depression and health-related Quality of Life improved noticeably after bariatric surgery. The causes are still not sufficiently clarified, but we assume that reduction of inflammation and increased physical well-being might be influencing factors.
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