Bariatric surgery restores visual cortical plasticity in nondiabetic subjects with obesity

• Published in: International Journal of Obesity Vol. 45; no. 8; pp. 1821 - 1829
• Main Authors: Daniele, Giuseppe, Lunghi, Claudia, Dardano, Angela, Binda, Paola, Ceccarini, Giovanni, Santini, Ferruccio, Giusti, Laura, Ciccarone, Annamaria, Bellini, Rosario, Moretto, Carlo, Morrone, Maria Concetta, Del Prato, Stefano
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2021; Nature Publishing Group
• Subjects: 692/163/2743/2815; 692/163/2743/393; Adolescent; Adult; Bariatric Surgery; Binocular vision; Brain; Brain-derived neurotrophic factor; Care and treatment; Cognitive science; Correlation; Deprivation; Endocrinology and metabolism; Epidemiology; Fasting; Female; Gastrointestinal surgery; Glucose; Health aspects; Health Promotion and Disease Prevention; Human health and pathology; Humans; Ingestion; Insulin; Insulin Resistance - physiology; Internal Medicine; Laboratory testing; Leptin; Life Sciences; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Monocular vision; Neuronal Plasticity - physiology; Neuroplasticity; Neuroscience; Obesity; Obesity, Morbid - epidemiology; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; Patient outcomes; Peptides; Public Health; Surgery; Synaptic plasticity; Vasoactive intestinal peptide; Visual cortex; Visual Cortex - physiology; Visual deprivation; Visual observation; Visual perception; Visual plasticity; Young Adult; Italy
• ISSN: 0307-0565; 1476-5497; 1476-5497; 0307-0565
• DOI: 10.1038/s41366-021-00851-0

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/m 2 ) 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 AUC active 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.