Kimberly Smith, PhD, Timothy Moran, PhD, Vidya Kamath, PhD, Carrie Speck, BS, Arnold Bakker, PhD, Susan Carnell, PhD, Kimberley E Steele, MD, PhD. The Johns Hopkins University School of Medicine
Background: Cognitive deficits are observed in individuals with obesity. While bariatric surgery can reverse these deficits, whether surgery type differentially influences cognitive outcome is unknown. We sought to compare the extent to which Vertical Sleeve Gastrectomy (VSG) and Roux-en Y Gastric Bypass (RYGB) ameliorate cognitive impairments associated with obesity.
Methods: A prospective longitudinal study was conducted at an academic bariatric center. Patients seeking VSG (N=18) or RYGB (N=15) were administered cognitive measures spanning the domains of attention [Hopkins Verbal Learning Test (HVLT) Recall and Letter Number Sequencing (LNS)], psychomotor speed [Stroop Color Trial, Symbol Digit Modality Test (SDMT), and Trail Making Part A], memory [HVLT Retained and HVLT Discrimination Index (DI)], and executive functioning (Stroop Color Word Trials and Trail Making Part A & B) prior to surgery and at 2 weeks and 3 months following surgery. Scores for each cognitive domain were calculated and compared between surgical cohorts using repeated-measures Analyses of Variance.
Results: Significant weight loss was observed at 2 weeks and 3 months following VSG (2 wk: -19.9 lbs, 3M: -46.8 lbs) and RYGB surgery (2 wk: -20.2 lbs, 3M: -48.4 lbs). This weight loss was accompanied by improvements in psychomotor speed in both groups at 3 months (VSG Stroop: 1.9, SDMT: 6.6, Trail A: -4.8; RYGB Stroop: 8.9, SDMT: 3.9, Trail A: -3.1). Patients receiving RYGB, but not VSG, showed significant increases in attention at 3 months (VSG Recall: 0.4, LNS: 1.0; RYGB Recall: 3.8, LNS: 2.7), while no changes in executive functioning or memory were observed from baseline measures in either group.
Conclusions: Our preliminary data demonstrate short-term improvements in specific domains of cognitive function following bariatric surgery and suggest that improvements in attention may be greater following RYGB than VSG procedures (supported by 1K23DK100559).
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95470
Program Number: S080
Presentation Session: Bariatric II – Revisions
Presentation Type: Podium