BACKGROUND Cognitive deficits are observed in individuals with obesity. While bariatric surgery can reverse these deficits, it remains unclear whether surgery type differentially influences cognitive outcome. We compared the extent to which vertical sleeve gastrectomy (VSG) and Roux-en Y gastric bypass (RYGB) ameliorated cognitive impairments associated with obesity. METHODS Female participants approved for VSG (N = 18) or RYGB (N = 18) were administered cognitive measures spanning the domains of attention [Hopkins Verbal Learning Test (HVLT) Trial 1 and Letter Number Sequencing], processing speed [Stroop Color Trial, Symbol Digit Modalities Test, and Trail Making Part A], memory [HVLT Retained and HVLT Discrimination Index], and executive functioning (Stroop Color Word Trials and Trail Making Part B-A) 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 2 weeks and 3 months following RYGB and VSG and was accompanied by improvements in processing speed and executive functioning. Patients who received RYGB also experienced improved attention as early as 2 weeks, which persisted at 3 months. This was not observed in individuals who underwent VSG. No changes in memory were observed from baseline measures in either group. CONCLUSIONS This is the first report of cognitive improvements following VSG and the first direct comparison of cognitive improvements following RYGB and VSG. Short-term improvements in specific domains of cognitive function are observed at the beginning of the active weight loss phase following bariatric surgery that persisted to 3 months. The anatomical distinction between the two surgeries and resulting differential metabolic profiles may be responsible for the improvements in attention observed following RYGB but not following VSG.

中文翻译：

---

垂直袖胃切除术和Roux-en Y胃搭桥术后认知功能的短期改善：直接比较研究。

背景技术在肥胖个体中观察到认知缺陷。减肥手术可以逆转这些缺陷，但尚不清楚手术类型是否会不同地影响认知结果。我们比较了垂直袖胃切除术（VSG）和Roux-en Y胃搭桥术（RYGB）改善与肥胖相关的认知障碍的程度。方法对获准参加VSG（N = 18）或RYGB（N = 18）的女性参与者进行认知措施，涉及注意力领域[霍普金斯语言学习测验（HVLT）试验1和字母编号排序]，处理速度[Stroop颜色试验符号数字模态测试和追踪制作A部分，内存[保留HVLT和HVLT鉴别指数]，手术前以及手术后2周和3个月的功能和执行功能（Stroop彩色单词测试和预告片制作BA）。计算每个认知领域的分数，并使用方差的重复测量分析在手术队列之间进行比较。结果RYGB和VSG术后2周和3个月观察到体重明显减轻，并且伴随着处理速度和执行功能的改善。早在2周时，接受RYGB的患者的注意力也得到改善，并持续3个月。在接受VSG的个体中未观察到这一点。两组的基线测量均未观察到记忆力的变化。结论这是VSG后认知改善的第一份报告，也是RYGB和VSG后认知改善的首次直接比较。在减肥手术后持续3个月的积极减肥阶段开始时，认知功能的特定领域出现了短期改善。两种手术之间的解剖区别以及由此产生的差异代谢状况可能是RYGB术后观察到的注意力改善的原因，而VSG术后则不是。