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Neuroimage. 2018 May 15;172:853-863. doi: 10.1016/j.neuroimage.2017.10.062. Epub 2017 Oct 28.

Gastric-bypass surgery induced widespread neural plasticity of the obese human brain.

Author information

1
IFB AdiposityDiseases, Leipzig University Medical Centre, Liebigstr. 20, 04103 Leipzig, Germany; Department of Nuclear Medicine, University Hospital Leipzig, Liebigstr. 18, 04103 Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany; Collaborative Research Centre 1052 Obesity Mechanisms, University of Leipzig, Leipzig, Germany.
2
Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany.
3
IFB AdiposityDiseases, Leipzig University Medical Centre, Liebigstr. 20, 04103 Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany.
4
IFB AdiposityDiseases, Leipzig University Medical Centre, Liebigstr. 20, 04103 Leipzig, Germany; Department of Neurology, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp Place 1, 44789 Bochum, Germany; Collaborative Research Centre 874 Integration and Representation of Sensory Processes, Ruhr-University Bochum, 44801 Bochum, Germany.
5
Department of Behavioral Epidemiology, Department of Psychology, Technische Universität Dresden, Zellescher Weg 18, 01062 Dresden, Germany.
6
IFB AdiposityDiseases, Leipzig University Medical Centre, Liebigstr. 20, 04103 Leipzig, Germany; Department of Bariatric Surgery, University Hospital Leipzig, Liebigstr. 18, 04103 Leipzig, Germany.
7
IFB AdiposityDiseases, Leipzig University Medical Centre, Liebigstr. 20, 04103 Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany; Collaborative Research Centre 1052 Obesity Mechanisms, University of Leipzig, Leipzig, Germany; Department of Neurology, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp Place 1, 44789 Bochum, Germany; Collaborative Research Centre 874 Integration and Representation of Sensory Processes, Ruhr-University Bochum, 44801 Bochum, Germany. Electronic address: burkhard.v.pleger@rub.de.

Abstract

Bariatric surgery has become the gold standard for the treatment of morbid obesity (body mass index (BMI) ≥ 40 kg/m2), but only few studies investigated its plastic influences on the obese brain. In this longitudinal study, we combined structural and functional magnetic resonance brain imaging (MRI) in 27 patients (BMI 47.8 ± 5.5 kg/m2) undergoing gastric-bypass surgery and 14 non-obese matched controls (BMI 24.7 ± 3.4 kg/m2). Over the first year after surgery, patients presented widespread changes in white matter density (WMD) as well as gray matter density (GMD) in the cerebral cortex of all lobes, subcortical structures, the brainstem as well as the cerebellum, but no changes in white matter water diffusivity throughout the brain. Voxel-by-voxel regression analyses revealed that all GMD and WMD changes were well associated with elevated regional homogeneity of spontaneous neural activity (ReHo) in blood-oxygenation level-dependent signals. Spatial-temporal integration of structural and functional MRI suggests that gastric-bypass surgery induces widespread plastic changes in brain structure that concurrently homogenizes the functional profile of the cortex, subcortical regions as well as white matter structures.

KEYWORDS:

ALFF; Amplitudes of low frequency fluctuations; Bariatric surgery; Body weight; Brain plasticity; Gastric-bypass surgery; Gray matter density; Magnetic resonance imaging; ReHo; Regional homogeneity; White matter density; white matter diffusion

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