Obesity (OB) is associated with cognitive impairments, though the mechanisms are not well understood. OB-related chronic systemic inflammation has been postulated to contribute to cognitive dysfunction. Inflammation improves after vertical sleeve gastrectomy (VSG) and could be a potential mechanism for cognitive improvement. We examined cognitive functions in morbidly obese adults without diabetes (n 10, mean age 35 ± 4 yrs, BMI 46±11, A1C 5.3±0.4) before and 6 months after VSG. Blood inflammatory markers including IL 6 and CRP were quantified at both assessments. Paired t-tests were used to index pre versus post VSG changes. Spearman correlations quantified associations between cognition and inflammatory markers. There were post VSG improvements in bilateral fine motor skills (Grooved Pegboard, dominant 73 ±21.2 vs. 61 ±8.0, p 0.003, non-dominant 81 ± 24 vs. 67±9 p 0.01), working memory (backward digit span 5.2 ±1.8 vs. 6.1±1.2, p 0.18; NIH Toolbox List Sort Working Memory 102 ± 14 vs. 108 ± 11, p 0.069), and Fluid Reasoning (NIH Toolbox 94 ± 18 vs. 102 ±17, p 0.048). Depression levels (Beck Inventory) significantly decreased; levels were sub-clinical prior to VSG. Functions that remained stable pre to post VSG included estimated nonverbal and verbal IQ (Matrix Reasoning and Picture Vocabulary Tasks), verbal learning (Rey Auditory Verbal Learning Test), basic attention (Digit span forward), and self-reported impulsivity. When pre-to-post VSG changes in cognitive performance was correlated with pre-to-post VSG changes in systemic inflammation (IL6 and CRP levels), decreased inflammation was associated with improvements in working memory and other fluid abilities (r’s from .4 to .8). These findings are novel and show that cognitive function improves after VSG in obese subjects without diabetes and inflammation may contribute to cognitive alterations in OB.


A. Moheet: None. N. Rubin: None. L.E. Eberly: None. S. Ikramuddin: Other Relationship; Self; Reshape Life Sciences (formerly EnteroMedics). M. Luciana: None.


National Institutes of Health (R21NS101140)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.