PMID- 28894291 OWN - NLM STAT- MEDLINE DCOM- 20190325 LR - 20190816 IS - 1476-5497 (Electronic) IS - 0307-0565 (Print) IS - 0307-0565 (Linking) VI - 42 IP - 4 DP - 2018 Apr TI - Neural predictors of 12-month weight loss outcomes following bariatric surgery. PG - 785-793 LID - 10.1038/ijo.2017.190 [doi] AB - BACKGROUND/OBJECTIVES: Despite the effectiveness of bariatric surgery, there is still substantial variability in long-term weight outcomes and few factors with predictive power to explain this variability. Neuroimaging may provide a novel biomarker with utility beyond other commonly used variables in bariatric surgery trials to improve prediction of long-term weight-loss outcomes. The purpose of this study was to evaluate the effects of sleeve gastrectomy (SG) on reward and cognitive control circuitry postsurgery and determine the extent to which baseline brain activity predicts weight loss at 12-month postsurgery. SUBJECTS/METHODS: Using a longitudinal design, behavioral, hormone and neuroimaging data (during a desire for palatable food regulation paradigm) were collected from 18 patients undergoing SG at baseline (<1 month prior) and 12-month post-SG. RESULTS: SG patients lost an average of 29.0% of their weight (percentage of total weight loss (%TWL)) at 12-month post-SG, with significant variability (range: 16.0-43.5%). Maladaptive eating behaviors (uncontrolled, emotional and externally cued eating) improved (P<0.01), in parallel with reductions in fasting hormones (acyl ghrelin, leptin, glucose, insulin; P<0.05). Brain activity in the nucleus accumbens (NAcc), caudate, pallidum and amygdala during desire for palatable food enhancement vs regulation decreased from baseline to 12 months (P (family-wise error (FWE))<0.05). Dorsolateral and dorsomedial prefrontal cortex activity during desire for palatable food regulation (vs enhancement) increased from baseline to 12 months (P(FWE)<0.05). Baseline activity in the NAcc and hypothalamus during desire for palatable food enhancement was significantly predictive of %TWL at 12 months (P (FWE)<0.05), superior to behavioral and hormone predictors, which did not significantly predict %TWL (P>0.10). Using stepwise linear regression, left NAcc activity accounted for 54% of the explained variance in %TWL at 12 months. CONCLUSIONS: Consistent with previous obesity studies, reward-related neural circuit activity may serve as an objective, relatively robust predictor of postsurgery weight loss. Replication in larger studies is necessary to determine true effect sizes for outcome prediction. FAU - Holsen, L M AU - Holsen LM AD - Division of Women's Health, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA. AD - Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. FAU - Davidson, P AU - Davidson P AD - Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. AD - Center for Metabolic and Bariatric Surgery, Department of Surgery, Brigham & Women's Hospital, Boston, MA, USA. FAU - Cerit, H AU - Cerit H AD - Division of Women's Health, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. FAU - Hye, T AU - Hye T AD - Division of Women's Health, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA. FAU - Moondra, P AU - Moondra P AD - Division of Women's Health, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA. FAU - Haimovici, F AU - Haimovici F AD - Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. FAU - Sogg, S AU - Sogg S AD - Harvard Medical School, Boston, MA, USA. AD - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. AD - MGH Weight Center, Massachusetts General Hospital, Boston, MA, USA. FAU - Shikora, S AU - Shikora S AD - Harvard Medical School, Boston, MA, USA. AD - Center for Metabolic and Bariatric Surgery, Department of Surgery, Brigham & Women's Hospital, Boston, MA, USA. FAU - Goldstein, J M AU - Goldstein JM AD - Division of Women's Health, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA. AD - Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. AD - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. AD - Division of Psychiatric Neuroscience, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, USA. FAU - Evins, A E AU - Evins AE AD - Harvard Medical School, Boston, MA, USA. AD - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. AD - Division of Psychiatric Neuroscience, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, USA. FAU - Stoeckel, L E AU - Stoeckel LE AD - Harvard Medical School, Boston, MA, USA. AD - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. AD - Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA. LA - eng GR - K01 MH091222/MH/NIMH NIH HHS/United States GR - P30 DK040561/DK/NIDDK NIH HHS/United States GR - R01 DK104772/DK/NIDDK NIH HHS/United States GR - UL1 RR025758/RR/NCRR NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20170814 PL - England TA - Int J Obes (Lond) JT - International journal of obesity (2005) JID - 101256108 SB - IM MH - Adult MH - Bariatric Surgery/*statistics & numerical data MH - Brain/diagnostic imaging/*physiology MH - Feeding Behavior/*physiology MH - Female MH - Humans MH - Longitudinal Studies MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Neuroimaging MH - Treatment Outcome MH - Weight Loss/*physiology PMC - PMC6319374 MID - NIHMS895296 COIS- Conflicts of Interest The authors have no conflicts of interest to disclose. EDAT- 2017/09/13 06:00 MHDA- 2019/03/26 06:00 PMCR- 2019/01/04 CRDT- 2017/09/13 06:00 PHST- 2017/04/19 00:00 [received] PHST- 2017/07/13 00:00 [revised] PHST- 2017/07/22 00:00 [accepted] PHST- 2017/09/13 06:00 [pubmed] PHST- 2019/03/26 06:00 [medline] PHST- 2017/09/13 06:00 [entrez] PHST- 2019/01/04 00:00 [pmc-release] AID - ijo2017190 [pii] AID - 10.1038/ijo.2017.190 [doi] PST - ppublish SO - Int J Obes (Lond). 2018 Apr;42(4):785-793. doi: 10.1038/ijo.2017.190. Epub 2017 Aug 14.