The Association between Reduced Inflammation and Cognitive Gains after Bariatric Surgery

Misty A.W. Hawkins, Michael L. Alosco, Mary Beth Spitznagel, Gladys Strain, Michael Devlin, Ronald Cohen, Ross D. Crosby, James E. Mitchell, John Gunstad

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Abstract

Objective Bariatric surgery is associated with improved cognitive function, although the mechanisms are unclear. Elevated inflammation is common in obesity and associated with impaired cognition. Inflammation decreases after bariatric surgery, implicating it as a possible mechanism for cognitive improvement. The objective of this study was to examine whether reduced inflammation is a possible mechanism for postoperative cognitive improvement in bariatric surgery patients. Methods Participants were 77 bariatric surgery patients who completed cognitive testing before surgery and 1 year postsurgery. Cognitive domains assessed were attention/executive function, language, and memory. High-sensitivity C-reactive protein (CRP) was assessed at both time points. Results Patients exhibited preoperative cognitive impairment, although improvements 1 year postsurgery were seen in both attention/executive function (mean [M; standard deviation {SD}]baseline = 53.57 [8.68] versus M (SD)follow-up= 60.32 [8.19]) and memory (M [SD]baseline= 44.96 [7.98] versus M [SD]follow-up= 51.55 [8.25]). CRP was elevated at baseline and fell into the normative range postsurgery (M [SD]baseline= 0.9 [0.7] versus M [SD]follow-up= 0.2 [0.3] mg/dl). Preoperative CRP was not associated with baseline cognitive function (β values = -0.10 to 0.02) and changes in CRP also did not correspond to changes in cognition postsurgery (β values = 0.02-0.11; p values >.05 for all domains). A trend was detected for smaller improvements in memory among participants with elevated baseline CRP (>0.30 mg/dl) versus those with normal levels (group × time: p =.083). Conclusions Improvements in high-sensitivity CRP were not associated with postoperative cognitive benefits. Future studies are needed to explore other inflammatory markers and potential mechanisms of cognitive improvement after bariatric surgery, including improved glycemic control and neurohormone changes.

Original languageEnglish
Pages (from-to)688-696
Number of pages9
JournalPsychosomatic Medicine
Volume77
Issue number6
DOIs
Publication statusPublished - 13 Jul 2015
Externally publishedYes

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Keywords

  • bariatric surgery
  • C-reactive protein
  • cognitive function
  • inflammation
  • obesity
  • prospective study

Cite this

Hawkins, M. A. W., Alosco, M. L., Spitznagel, M. B., Strain, G., Devlin, M., Cohen, R., ... Gunstad, J. (2015). The Association between Reduced Inflammation and Cognitive Gains after Bariatric Surgery. Psychosomatic Medicine, 77(6), 688-696. https://doi.org/10.1097/PSY.0000000000000125