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Short-term improvements in cognitive function following vertical sleeve gastrectomy and Roux-en Y gastric bypass: a direct comparison study

  • 2019 SAGES Oral
  • Published:
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Abstract

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.

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Acknowledgements

The authors would like to thank Civonnia Harris for her role in data collection. Funding for this research was provided by 1K23DK100559 from the National Institutes of Health to K.E.S. and The Dalio Foundation.

Funding

1K23DK100559 to K.E.S. and The Dalio Foundation.

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Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St., Phipps 316, Baltimore, MD, 21287, USA

    Kimberly R. Smith, Timothy H. Moran, Afroditi Papantoni, Caroline Speck, Arnold Bakker, Vidyulata Kamath & Susan Carnell

  2. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kimberley E. Steele

  3. Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Kimberley E. Steele

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  1. Kimberly R. Smith
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Correspondence to Kimberly R. Smith.

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Kimberly R. Smith, Timothy H. Moran, Afroditi Papantoni, Caroline Speck, Arnold Bakker, Vidyulata Kamath, Susan Carnell, and Kimberley E. Steele have no conflicts of interest and financial ties to disclose.

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Smith, K.R., Moran, T.H., Papantoni, A. et al. Short-term improvements in cognitive function following vertical sleeve gastrectomy and Roux-en Y gastric bypass: a direct comparison study. Surg Endosc 34, 2248–2257 (2020). https://doi.org/10.1007/s00464-019-07015-2

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