Resting-state brain connectivity changes in obese women after Roux-en-Y gastric bypass surgery: A longitudinal study

Gaia Olivo, Wei Zhou, Magnus Sundbom, Christina Zhukovsky, Pleunie Hogenkamp, Lamia Nikontovic, Julia Stark, Lyle Wiemerslage, Elna-Marie Larsson, Christian Benedict, Helgi B Schiöth, Gaia Olivo, Wei Zhou, Magnus Sundbom, Christina Zhukovsky, Pleunie Hogenkamp, Lamia Nikontovic, Julia Stark, Lyle Wiemerslage, Elna-Marie Larsson, Christian Benedict, Helgi B Schiöth

Abstract

Bariatric surgery is an effective method to rapidly induce weight loss in severely obese people, however its impact on brain functional connectivity after longer periods of follow-up is yet to be assessed. We investigated changes in connectivity in 16 severely obese women one month before, one month after and one year after Roux-en-Y gastric bypass surgery (RYGB). 12 lean controls were also enrolled. Resting-state fMRI was acquired for all participants following an overnight fast and after a 260 kcal load. Connectivity between regions involved in food-related saliency attribution and reward-driven eating behavior was stronger in presurgery patients compared to controls, but progressively weakened after follow-up. At one year, changes in networks related to cognitive control over eating and bodily perception also occurred. Connectivity between regions involved in emotional control and social cognition had a temporary reduction early after treatment but had increased again after one year of follow-up. Furthermore, we could predict the BMI loss by presurgery connectivity in areas linked to emotional control and social interaction. RYGBP seems to reshape brain functional connectivity, early affecting cognitive control over eating, and these changes could be an important part of the therapeutic effect of bariatric surgery.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Seed-to-target connectivity changes over time. The figure shows the seed-to-ROI connectivity found to be significantly different between groups. The red lines represent connections found to be stronger in presurgery patients (PS) compared to all other groups (lean controls, 1 month follow-up and 1 year follow-up). The yellow lines represent connections where a minor change occurred, as they were found to be stronger in presurgery patients compared with both lean controls (LS) and 1 month follow-up (1 m), but not to 1 year follow-up (1 y) nor between lean controls and 1 year follow-up. The green lines represent the connections where a change in connectivity was observed more slowly, as their connectivity was stronger in presurgery patients compared with lean controls and 1 year follow-up, but not compared with 1 month follow-up. All results were significant with a p 

Figure 2

Within-patients effect of the feeding…

Figure 2

Within-patients effect of the feeding condition on connectivity. The figure shows connections where…

Figure 2
Within-patients effect of the feeding condition on connectivity. The figure shows connections where connectivity was found to be greater in the sated state compared to the fasted state, in patients. Blue circles represent seeds regions; green circles represent target ROIs. The image was generated with the CONN software used for the analysis.

Figure 3

Positive correlation between baseline connectivity…

Figure 3

Positive correlation between baseline connectivity and BMI loss at 1 year follow-up. The…

Figure 3
Positive correlation between baseline connectivity and BMI loss at 1 year follow-up. The figures shows seed (black font) to target (grey font) connections where a positive correlations was found between presurgery connectivity and BMI loss over 1 year of follow-up. Results are corrected for multiple comparisons with a FDR approach. The image was generated with the CONN software used for the analysis.
Figure 2
Figure 2
Within-patients effect of the feeding condition on connectivity. The figure shows connections where connectivity was found to be greater in the sated state compared to the fasted state, in patients. Blue circles represent seeds regions; green circles represent target ROIs. The image was generated with the CONN software used for the analysis.
Figure 3
Figure 3
Positive correlation between baseline connectivity and BMI loss at 1 year follow-up. The figures shows seed (black font) to target (grey font) connections where a positive correlations was found between presurgery connectivity and BMI loss over 1 year of follow-up. Results are corrected for multiple comparisons with a FDR approach. The image was generated with the CONN software used for the analysis.

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