The effects of roux en y gastric bypass surgery on neurobehavioral symptom domains associated with severe obesity

• Type of Material: Article
• Authors: Dominique Musselman, University of Miami; Neeta Shenvi, Emory University; Amita Manatunga, Emory University; Andrew Miller, Emory University; Edward Lin, Emory University; Nana Gletsu-Miller, Purdue University
• Language: English
• Date: 2019-05-15
• Publisher: Elsevier Science Ltd.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 published by Elsevier.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.physbeh.2019.02.013
• Title of Journal or Parent Work: Physiology & Behavior
• Volume: 204
• Start Page: 86
• End Page: 92
• Grant/Funding Information: This work supported by R03 DK067167-01A1, R21 DK075745, and Atlanta Clinical and Translational Science Institute #UL1 RR025008.
• Keywords: Depression; Suicide risk; Science & Technology; Depressive symptoms; Behavioral Sciences; Women; Social Sciences; Bariatric surgery; Risk; Inflammatory markers; Inflammation; Visceral adipose tissue; Quality of life; Improvement; Psychology; Cognition; Cognitive decline; Psychology, Biological; Interleukin-6; Interferon-alpha; Life Sciences & Biomedicine
• Research Categories: Biology, Neuroscience; Psychology, Cognitive; Health Sciences, Medicine and Surgery; Psychology, Behavioral

Abstract

Background: Neurobehavioral symptoms and cognitive dysfunction related to mood disorders are present in individuals with severe obesity. We sought to determine acute improvements in these symptoms and relationships with adiposity, inflammation, and insulin sensitivity after roux-en-y gastric bypass (RYGB) surgery. Methods: The self-report Zung Depression Rating (ZDRS) and Neurotoxicity Rating (NRS) scales were administered before, and at 6-months after RYGB surgery in severely obese women (body mass index > 35 kg/m 2 ; N = 19). Symptom domains corresponding to depressed mood/suicide ideation, anxiety, cognitive, somatic, and neurovegetative symptoms were assessed. Biologic measures were of adiposity [leptin, abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue], inflammation [IL-6, C-reactive protein (CRP)], and insulin sensitivity (Si). Spearman correlations and linear regression (adjusted for biologic measures) assessed relationships between changes in biologic measures and changes in neurobehavioral domains. Results: By 6-months after RYGB, VAT, SAT, Si, CRP, and IL-6 had improved (p < .05). Anxiety, somatic, and neurovegetative symptoms domains improved (p < .05), but depressed mood/suicidal ideation and cognitive domains did not. Reductions in VAT were associated with decreases in neurovegetative symptoms (beta = 295 ± 85, p < .01). We also found significant positive longitudinal associations between IL-6 concentrations and minor changes in cognitive symptoms. Conclusion: Anxiety, somatic and neurovegetative symptoms, improved within 6 months after RYGB, but depressed mood/suicidal ideation and cognitive symptoms did not improve. Associations between visceral adiposity, IL-6 concentrations and neurovegetative and cognitive symptoms support links between obesity, inflammation and distinct neurobehavioral symptoms.