Douglas Research Centre, Department of Psychiatry, McGill University, Montreal, Canada; Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
Douglas Research Centre, Department of Psychiatry, McGill University, Montreal, Canada.
Neuroimage. 2022 Oct 1;259:119415. doi: 10.1016/j.neuroimage.2022.119415. Epub 2022 Jun 24.
Individuals living with obesity tend to have increased brain age, reflecting poorer brain health likely due to grey and white matter atrophy related to obesity. However, it is unclear if older brain age associated with obesity can be reversed following weight loss and cardiometabolic health improvement. The aim of this study was to assess the impact of weight loss and cardiometabolic improvement following bariatric surgery on brain health, as measured by change in brain age estimated based on voxel-based morphometry (VBM) measurements. We used three distinct datasets to perform this study: 1) CamCAN dataset to train the brain age prediction model, 2) Human Connectome Project (HCP) dataset to investigate whether individuals with obesity have greater brain age than individuals with normal weight, and 3) pre-surgery, as well as 4, 12, and 24 month post-surgery data from participants (n = 87, age: 44.0 ± 9.2 years, BMI: 43.9 ± 4.2 kg/m) who underwent a bariatric surgery to investigate whether weight loss and cardiometabolic improvement as a result of bariatric surgery lowers the brain age. As expected, our results from the HCP dataset showed a higher brain age for individuals with obesity compared to individuals with normal weight (T-value = 7.08, p-value < 0.0001). We also found significant improvement in brain health, indicated by a decrease of 2.9 and 5.6 years in adjusted delta age at 12 and 24 months following bariatric surgery compared to baseline (p-value < 0.0005 for both). While the overall effect seemed to be driven by a global change across all brain regions and not from a specific region, our exploratory analysis showed lower delta age in certain brain regions (mainly in somatomotor, visual, and ventral attention networks) at 24 months. This reduced age was also associated with post-surgery improvements in BMI, systolic/diastolic blood pressure, and HOMA-IR (T-value=4.29, T-value=4.67, T-value=4.12, T-value=3.16, all p-values < 0.05). In conclusion, these results suggest that obesity-related brain health abnormalities (as measured by delta age) might be reversed by bariatric surgery-induced weight loss and widespread improvements in cardiometabolic alterations.
肥胖个体的大脑年龄往往会增加，这反映出较差的大脑健康状况，可能是由于肥胖导致的灰质和白质萎缩。然而，肥胖相关的大脑年龄增加是否可以在减肥和改善心血管代谢健康后逆转尚不清楚。本研究的目的是评估减肥和减肥后对大脑健康的影响肥胖患者接受减肥手术后心血管代谢改善，通过基于体素形态计量学（VBM）测量的大脑年龄估计变化来衡量。我们使用了三个不同的数据集来进行这项研究：1）CamCAN 数据集来训练大脑年龄预测模型，2）人类连接组计划（HCP）数据集来研究肥胖个体的大脑年龄是否高于正常体重个体，以及 3）术前以及术后 4、12 和 24 个月的参与者数据（n=87，年龄：44.0±9.2 岁，BMI：43.9±4.2kg/m）接受减肥手术以研究减肥和心血管代谢改善是否会降低大脑年龄。正如预期的那样，我们从 HCP 数据集获得的结果显示，肥胖个体的大脑年龄高于正常体重个体（T 值=7.08，p 值<0.0001）。我们还发现大脑健康有了显著改善，与基线相比，减肥手术后 12 个月和 24 个月的调整后的年龄差异分别减少了 2.9 和 5.6 岁（p 值均<0.0005）。虽然整体效果似乎是由所有大脑区域的整体变化驱动的，而不是由特定区域驱动的，但我们的探索性分析显示，在 24 个月时，某些大脑区域（主要是躯体运动、视觉和腹侧注意力网络）的年龄差异较小。这种年龄的降低也与术后 BMI、收缩压/舒张压和 HOMA-IR 的改善相关（T 值=4.29，T 值=4.67，T 值=4.12，T 值=3.16，所有 p 值均<0.05）。总之，这些结果表明，减肥手术引起的体重减轻和广泛改善的心血管代谢改变可能逆转肥胖相关的大脑健康异常（以年龄差异衡量）。
