Cognitive Function and Brain Plasticity in Obese Patients—The Impact of Bariatric Surgery
Bibliographic record
Abstract
Background and Aim: Obesity adversely affects brain function, but the effect of bariatric surgery on cognitive function is still poorly evaluated. We assessed metabolic parameters and cognitive function in obese patients before and after bariatric surgery (RYGB). Methods: A 75g OGTT was performed in 10 nondiabetic obese patients (BMI 46.0±5.4 kg/m2; age 43.6±10.5 years; HbA1c 43.3±4.6 mmol/mol) before and 6-months after RYGB for measurements of metabolic parameters. Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were administered; neuronal plasticity (NP) of the visual cortex was measured as change in ocular dominance after 120 min monocular deprivation. No subject with drugs or alcohol abuse, psychiatric illness, head injury, brain tumor, dementia, epilepsy, learning disorder, developmental disability, and impaired sensory function were included. Results: At baseline median MMSE score was 28.5 (range 25-30) and median MoCA score 26.5 (range 21-30), indicating early cognitive abnormalities (MoCA<26 points). Six months after RYGB, BMI decreased to 35.2±6.1 kg/m2 (p=0.004) and glucose tolerance did not change. HOMA-IR (from 5.1±2.3 to 1.6±1.1) and disposition index (from 3.3±4.6 to 35.0±41.0) all improved (p<0.05); post-OGTT GLP-1 increased from 5336.6±2262.6 to 11132.3±3412.2 pmol/lx120min (p<0.05) and fasting plasma leptin decreased from 80.0±46.7 to 13.1±6.6 pmol/l (p<0.008). NP increased from 0.03±0.1 to 0.11±0.14 (p<0.01). Cognitive performance improved in all subjects (MMSE: 30, range 28-30; MoCA: 28.5, range 24-30; both p=0.03 or less vs. baseline). There was no correlation between MoCA and metabolic changes though it was positively correlated with NP post-RYGB (p=0.04). Conclusion: Morbid obese subjects have subclinical cognitive impairments and brain plasticity alterations that significantly improve after RYGB. While no correlation was found between metabolic and hormonal changes, NP was positively associated with MoCA score. Disclosure A. Dardano: None. G. Daniele: None. C. Lunghi: None. A. Ciccarone: None. F. Santini: None. G. Ceccarini: None. C. Moretto: None. G. Penno: None. R. Miccoli: None. M. Morrone: None. S. Del Prato: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, GlaxoSmithKline plc., Intarcia Therapeutics, Inc., Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Servier, Sanofi, Takeda Pharmaceuticals U.S.A., Inc.. Research Support; Self; Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis Pharmaceuticals Corporation, Takeda Pharmaceuticals U.S.A., Inc.. Advisory Panel; Self; Janssen Biotech, Inc., Abbott.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".