Sandoval Hugo, Clapp Benjamin, O'Dell Laura E, Clegg Deborah J
Department of Radiology, Texas Tech Health Science Center El Paso, El Paso, Texas.
Department of Surgery, Texas Tech Health Science Center El Paso, El Paso, Texas.
Surg Obes Relat Dis. 2025 Jan;21(1):85-92. doi: 10.1016/j.soard.2024.08.036. Epub 2024 Sep 10.
According to the World Health Organization, obesity is one of the most significant health issues currently because it increases risk for type 2 diabetes and cancer, heart disease, bone health, reproduction, and quality of living and it impacts approximately 500 million adults worldwide. This review analyzed the existing literature focusing on the effects of Metabolic and bariatric surgeries (MBS), including Roux-en-Y gastric bypass and sleeve gastrectomy on changes in brain function and anatomy using magnetic resonance imaging (MRI) technology. A PubMed search using the key words bariatric surgery and MRI conducted in December 2023 resulted in 544 articles. Our literature review identified 24 studies addressing neuroanatomic, neurophysiological, cognitive, and behavioral changes that occurred at different time intervals after different types of bariatric surgery. Our review of the literature found several reports indicating that MBS reverse neuroanatomic alterations and changes in functional connectivity associated with obesity. There were also reported improvements in cognitive performance, memory, executive function, attention, as well as decreased gustatory brain responses to food cues and resting state measures following bariatric surgery. There were instances of improved neural functioning associated with weight loss, suggesting that some neuroanatomic changes can be reversed following weight loss induced by bariatric surgery. Additionally, there were data suggesting that brain connectivity and metabolic health are improved following a bariatric surgical intervention. Together, the existing literature indicates an overall improvement in brain connectivity and health outcomes following bariatric surgery.
根据世界卫生组织的说法,肥胖是当前最严重的健康问题之一,因为它会增加患2型糖尿病、癌症、心脏病、影响骨骼健康、生殖及生活质量的风险,且全球约有5亿成年人受其影响。本综述分析了现有文献,重点关注代谢和减重手术(MBS)的影响,包括 Roux-en-Y 胃旁路术和袖状胃切除术对脑功能和脑解剖结构变化的影响,采用的是磁共振成像(MRI)技术。2023年12月在PubMed上使用关键词“减重手术”和“MRI”进行搜索,共得到544篇文章。我们的文献综述确定了24项研究,这些研究探讨了不同类型的减重手术后在不同时间间隔发生的神经解剖学、神经生理学、认知和行为变化。我们对文献的综述发现,有几份报告表明,代谢和减重手术可逆转与肥胖相关的神经解剖学改变和功能连接变化。还有报告称,减重手术后认知表现、记忆力、执行功能、注意力有所改善,对食物线索的味觉脑反应及静息状态测量结果也有所下降。有实例表明,神经功能改善与体重减轻有关,这表明减重手术导致体重减轻后,一些神经解剖学变化是可以逆转的。此外,有数据表明,减重手术干预后,大脑连接性和代谢健康状况得到改善。总体而言,现有文献表明减重手术后大脑连接性和健康结果有全面改善。