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Brain functional connectivity differences between responders and non-responders to sleeve gastrectomy

  • Functional Neuroradiology
  • Published:
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Abstract

Purpose

To compare resting-state functional connectivity (RSFC) of obese patients responders or non-responders to sleeve gastrectomy (SG) with a group of obese patients with no past medical history of metabolic or bariatric surgery.

Methods

MR images were acquired at 1.5 Tesla. Resting-state fMRI data were analyzed with statistical significance threshold set at p < 0.05, family-wise error (FWE) corrected.

Results

Sixty-two subjects were enrolled: 20 controls (age range 25–64; 14 females), 24 responders (excess weight loss > 50%; age range 23–68; 17 females), and 18 non-responders to sleeve gastrectomy (SG) (excess weight loss < 50%; age range 23–67; 13 females). About within-network RSFC, responders showed significantly lower RSFC with respect to both controls and non-responders in the default mode and frontoparietal networks, positively correlating with psychological scores. Non-responders showed significantly higher (p < 0.05, family-wise error (few) corrected) RSFC in regions of the lateral visual network as compared to controls. Regarding between-network RSFC, responders showed significantly higher anti-correlation between executive control and salience networks (p < 0.05, FWE corrected) with respect to both controls and non-responders. Significant positive correlation (Spearman rho = 0.48, p = 0.0012) was found between % of excess weight loss and executive control-salience network RSFC.

Conclusion

There are differences in brain functional connectivity in either responders or non-responders patients to SG. The present results offer new insights into the neural correlates of outcome in patients who undergo SG and expand knowledge about neural mechanisms which may be related to surgical response.

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Data availability

Data are available upon reasonable requests of collaboration.

Code availability

None.

Abbreviations

RSFC:

Resting-state functional connectivity

SG:

Sleeve gastrectomy

FWE:

Family-wise error

EWL:

Excess weight loss

fMRI:

Functional MRI

BOLD:

Blood oxygen level-dependent

FC:

Functional connectivity

TIV:

Total intracranial volume

TFCE:

Threshold-free cluster enhancement

%EWL:

Percentage of excess weight loss

BES:

Binge Eating Scale

SOM:

Somatization

OBS\COMP:

Obsessive-compulsive

IS:

Interpersonal sensitivity

PAR:

Paranoid thought

GSI:

General Symptom Index

RSNs:

Resting-state networks

ICA:

Independent component analysis

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Authors and Affiliations

  1. Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy

    Carlo A. Mallio, Federica Spani & Carlo C. Quattrocchi

  2. Unit of Bariatric Surgery, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy

    Giuseppe Spagnolo, Ida Francesca Gallo & Vincenzo Bruni

  3. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Claudia Piervincenzi

  4. Department of Radiology, IRCCS NEUROMED, Pozzilli, Italy

    Nikolaos Petsas

  5. Department of Biotechnological and Applied Clinical Science, University of L’Aquila AQ, L’Aquila, Italy

    Danilo Boccetti

  6. Clinical Psychological Service, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy

    Antonella Sisto & Livia Quintiliani

  7. Department of Health Sciences, Chair of Medical Statistics, University of Catanzaro Magna Græcia, Catanzaro, Italy

    Gianfranco Di Gennaro

Authors
  1. Carlo A. Mallio
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  2. Giuseppe Spagnolo
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  6. Federica Spani
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  11. Vincenzo Bruni
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  12. Carlo C. Quattrocchi
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Contributions

All the authors made substantial contributions to all the categories established by the International Committee of Medical Journal Editors (ICMJE) guidelines on authorship:

1. Carlo Augusto Mallio: conception and design, acquisition of data, analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

2. Giuseppe Spagnolo: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

3. Claudia Piervincenzi: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

4. Nikolaos Petsas: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

5. Danilo Boccetti: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

6. Federica Spani: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

7. Ida Francesca Gallo: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

8. Antonella Sisto: acquisition of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

9. Livia Quintiliani: acquisition of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

10. Gianfranco Di Gennaro: acquisition of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

11. Vincenzo Bruni: analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

12. Carlo Cosimo Quattrocchi: conception and design, acquisition of data, analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Carlo A. Mallio.

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Mallio, C.A., Spagnolo, G., Piervincenzi, C. et al. Brain functional connectivity differences between responders and non-responders to sleeve gastrectomy. Neuroradiology 65, 131–143 (2023). https://doi.org/10.1007/s00234-022-03043-3

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