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Bariatric Surgery

Bariatric surgery restores visual cortical plasticity in nondiabetic subjects with obesity

Abstract

Background/objectives

Obesity leads to changes in synaptic plasticity. We aimed at investigating the impact of bariatric surgery (RYGB) on visual neural plasticity (NP) and its relationship with the main gut peptides, leptin, and brain-derived neurotrophic factor (BDNF).

Subjects/methods

NP was assessed testing binocular rivalry before and after 2 h of monocular deprivation (index of visual brain plasticity) in 15 subjects with obesity (age 42.3 ± 9.8 years; BMI 46.1 ± 4.9 kg/m2) before and after RYGB. Gut peptides, leptin, and BDNF were obtained at baseline and 6 months after surgery in 13 subjects.

Results

A significant reduction in BMI (p < 0.001 vs. baseline) and a significant increase of disposition index (DI, p = 0.02 vs baseline) were observed after RYGB. Total and active GLP-1 release in response to glucose ingestion significantly increased after RYGB, while no changes occurred in VIP, GIP, and BDNF levels. Fasting leptin concentration was lower after RYGB (p = 0.001 vs. baseline). Following RYGB, NP was progressively restored (p < 0.002). NP was correlated with DI and fasting glucose at baseline (r = 0.75, p = 0.01; r = −0.7, p = 0.02; respectively), but not with BMI. A positive correlation between post–pre-RYGB changes in AUCactive GLP−1 and NP was observed (r = 0.70, p < 0.01). Leptin was inversely correlated with NP 6 months after surgery (r = −0.63, p = 0.02). No correlation was observed between GIP, VIP, BDNF, and NP.

Conclusions

Visual plasticity is altered in subjects with obesity, and it can be restored after RYGB. The improvement may be mediated by amelioration of insulin sensitivity, increased GLP-1 levels, and reduced leptin levels.

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Fig. 1: Plasma concentrations of gut hormones during OGTT.
Fig. 2: Effect of bariatric surgery on plasticity index and its correlation with metabolic parameters.
Fig. 3: Correlations between plasticity index change and hormones change after bariatric surgery.

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Funding

This work was supported by grant from the University of Pisa (Project Code: PRA_2016_44), by ERC (H2020) Pupiltraits and PRIN MIUR 2017.

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Contributions

GD, MCM, and SDP conceived the objective and designed the study. GD, AD, GC, FS, and AC have screened subjects with obesity. GD and AD collected the study data, analyzed the result, and wrote the first version of the manuscript. CL, PB, and MCM designed, measured, and analyzed the visual performance to asses visual plasticity. RB and CM performed RYGB. LG conducted the laboratory analysis. All authors have reviewed and approved the final version of the manuscript. SDP is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Stefano Del Prato.

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Daniele, G., Lunghi, C., Dardano, A. et al. Bariatric surgery restores visual cortical plasticity in nondiabetic subjects with obesity. Int J Obes 45, 1821–1829 (2021). https://doi.org/10.1038/s41366-021-00851-0

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