Sleeve Gastrectomy Recovering Disordered Brain Function in Subjects with Obesity: a Longitudinal fMRI Study
Sleeve Gastrectomy Recovering Disordered Brain Function in Subjects with Obesity: a Longitudinal fMRI Study
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袖状胃切除术恢复肥胖受试者紊乱的脑功能：一项纵向功能磁共振成像研究
DOI：
10.1007/s11695-018-3178-z
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发表时间：
2018-08-01
期刊：
影响因子：
2.9
通讯作者：
Shan, Baoci
中科院分区：
文献类型：
--
作者：
Li, Panlong;Shan, Han;Shan, Baoci
减肥手术可以恢复大脑皮层的局部功能障碍。然而，减肥手术是否能恢复肥胖患者的整体水平功能障碍尚不清楚。本研究的目的是通过静息态功能磁共振成像（fMRI）研究减肥手术对肥胖患者整体水平功能障碍的影响。
静息态fMRI用于研究34例肥胖患者和34例年龄及性别匹配的正常体重者的全脑功能障碍，其中17例肥胖患者接受了袖状胃切除术。采用全脑低频波动振幅分数（fALFF）和功能连接（FC）来评估术前患者、术后患者和对照组之间的大脑功能差异。
与对照组相比，术前患者在奖赏处理和认知控制区域（如眶额皮质、额中回、额上回和直回）的静息态活动降低。重要的是，在这些区域还发现功能连接增强。相关性分析表明，体重指数（BMI）与这些活动降低和功能连接增强有关。更重要的是，减肥手术恢复了这些区域的功能障碍。
这些结果表明，减肥手术诱导的体重减轻可以逆转肥胖患者的整体水平功能障碍。这些区域的功能障碍可能在肥胖的发展中起关键作用，可能作为肥胖治疗的一个生物标志物。
Bariatric surgery could recover regional dysfunction of cerebral cortex. However, it is unknown whether bariatric surgery could recover the global-level dysfunction in subjects with obesity. The aim of this study was to investigate the effect of bariatric surgery on global-level dysfunction in subjects with obesity by resting-state functional magnetic resonance imaging (fMRI).Resting-state fMRI was used to investigate dysfunction of whole-brain in 34 subjects with obesity and 34 age-and gender-matched normal-weight subjects, in which 17 subjects with obesity received sleeve gastrectomy. Fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) among the whole brain were used to estimate the brain functional differences among the preoperative subjects, postoperative subjects, and the controls.The preoperative subjects compared to controls had decreased resting-state activities in reward processing and cognitive control regions such as orbitofrontal cortex, middle frontal gyrus, superior frontal gyrus, and gyrus rectus. It was important that increased FC was also found in these regions. Correlation analysis showed that body mass index (BMI) was associated with these decreased activity and increased FC. More importantly, the dysfunction in these regions was recovered by the bariatric surgery.These results suggest that bariatric surgery-induced weight loss could reverse the global-level dysfunction in subjects with obesity. The dysfunction in these regions might play a key role in the development of obesity, which might serve as a biomarker in the treatment of obesity.