Cognitive improvement after bariatric surgery in obesity: neuronal correlates and underlying mechanisms

肥胖症减肥手术后的认知改善：神经元相关性和潜在机制

• 批准号: 329488092
• 负责人: Professorin Dr. Agnes Flöel
• 金额: --
• 依托单位: Tagesklinik für kognitive Neurologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2017
• 资助国家: 德国
• 起止时间: 2016-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/329488092?language=en
• 关键词: Cognitive; improvement; after; bariatric; surgery

Overweight and obesity are on the rise worldwide. These conditions are linked with severe co-morbidities including hypertension, disturbances in lipid metabolism, insulin resistance and type 2 diabetes mellitus, as well as sleep apnea, all of which have already been extensively studied in a number of studies. Currently, negative effects of overweight and obesity on brain function and structure become increasingly recognized. In the stage of morbid obesity, a conventional therapy aiming at weight loss is usually frustrating, so that bariatric surgery has proven to be a promising alter native. Here, food supply and ingestion is restricted by surgery on the gastrointestinal system, causing considerable loss of weight. First studies could show cognitive improvements after surgery, for example in word production and in memory formation. However, the impact of bariatric surgery , particularly restrictive vs restrictive and maladsorptive approaches, on brain function and structure remains incompletely understood. Effects at the neuronal level have not been studied (for example, changes in gray matter volume and functional and structural connectivity of individual brain regions such as the hippocampus; reward system). Also, the mechanisms underlying these improvements are unclear (for example, with regard to vascular changes, anti-inflammatory processes, insulin -glucose metabolism, or other hormones of the gastro-intestinal tract, immunological parameters, gut micorbiom). With the current project we aim to answer the following questions:1) Does bariatric surgery with a restrictive and maladsorptive approach, compared waiting list control group, improve cognitive performance? 2) Does this bariatric surgery lead to improvements in structure and connectivity of gray and white matter of the brain, and neural activity in response to neutral, high- and low-caloric stimuli? 3) Does this bariatric surgery induce improvements in blood pressure, energy and lipid metabolism, inflammatory processes, gastrointestinal hormones, immunological parameters, gut microbiom? Long-term sequelae of 1) to 3), and comparison with restrictive-only bariatric surgery?The answers to these research questions will provide an important contribution in the evaluation of bariatric surgery as a clinical treatment, as cognitive functions are critical for quality of life and social participation. Moreover, we will gain outstanding scientific insights into the mechanistic link between obesity and cognition.

超重和肥胖在全球范围内正在上升。这些疾病与严重的合并症有关，包括高血压，脂质代谢障碍，胰岛素抵抗和2型糖尿病以及睡眠呼吸暂停，所有这些都已经在许多研究中进行了广泛的研究。当前，超重和肥胖对脑功能和结构的负面影响越来越多。在病态肥胖症的阶段，旨在减肥的常规疗法通常令人沮丧，因此减肥手术已被证明是有前途的替代品。在这里，食物供应和摄入受到胃肠系统手术的限制，导致体重减轻。第一项研究可以显示手术后的认知改善，例如单词产生和记忆形成。但是，减肥手术，特别是限制性和疾病方法的影响，对脑功能和结构的影响尚不完全理解。尚未研究神经元水平的效果（例如，灰质体积的变化以及单个大脑区域（例如海马）的功能和结构连通性；奖励系统）。同样，这些改进的基础机制尚不清楚（例如，关于血管变化，抗炎过程，胰岛素 - 葡萄糖代谢或胃肠道肠道，免疫学参数，肠道胶状型的其他激素）。通过当前的项目，我们旨在回答以下问题：1）比较候补名单对照组的限制性和疾病方法的减肥手术是否会提高认知表现？ 2）这种减肥手术是否会改善大脑的灰色和白质的结构和连通性，以及对中性，高和低过滤的刺激的神经活动？ 3）这种减肥手术是否会诱导血压，能量和脂质代谢，炎症过程，胃肠道激素，免疫学参数，肠道微生物的改善？长期后遗症1）至3），并与仅限限制性减肥手术进行比较？这些研究问题的答案将为减肥手术作为一种临床治疗的评估提供重要贡献，因为认知功能对生活和社会参与的质量至关重要。此外，我们将获得对肥胖与认知之间机械联系的出色科学见解。