Exercise modifies hypothalamic connectivity and brain functional networks in women after bariatric surgery: a randomized clinical trial

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Merege-Filho, Carlos A. A. ; Gil, Saulo S. ; Kirwan, John P. ; Murai, Igor H. ; Dantas, Wagner S. ; Nucci, Mariana P. ; Pastorello, Bruno ; de Lima, Alisson Padilha ; Bazan, Paulo R. ; Pereira, Rosa M. R. ; de Sa-Pinto, Ana L. ; Lima, Fernanda R. ; Brucki, Sonia M. D. ; de Cleva, Roberto ; Santo, Marco A. ; Leite, Claudia da Costa ; Otaduy, Maria Concepcion Garcia ; Roschel, Hamilton ; Gualano, Bruno

• Document type: Journal article
• Source: International Journal of Obesity; v. N/A, p. 10-pg., 2022-12-30.

Abstract

BackgroundObesity is a disease that may involve disrupted connectivity of brain networks. Bariatric surgery is an effective treatment for obesity, and the positive effects on obesity-related conditions may be enhanced by exercise. Herein, we aimed to investigate the possible synergistic effects of Roux-en-Y Gastric Bypass (RYGB) and exercise training on brain functional networks. MethodsThirty women eligible for bariatric surgery were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 15, age = 41.0 & PLUSMN; 7.3 years) or RYGB plus Exercise Training (RYGB + ET: n = 15, age = 41.9 & PLUSMN; 7.2 years). Clinical, laboratory, and brain functional connectivity parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6-month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). ResultsExercise superimposed on bariatric surgery (RYGB + ET) increased connectivity between hypothalamus and sensorial regions (seed-to-voxel analyses of hypothalamic connectivity), and decreased default mode network (DMN) and posterior salience (pSAL) network connectivity (ROI-to-ROI analyses of brain networks connectivity) when compared to RYGB alone (all p-FDR < 0.05). Increases in basal ganglia (BG) network connectivity were only observed in the exercised training group (within-group analyses). ConclusionExercise training is an important component in the management of post-bariatric patients and may improve the hypothalamic connectivity and brain functional networks that are involved in controlling food intake. (AU)

• FAPESP's process: 16/10993-5 - Effects of exercise training in patients undergoing bariatric surgery: a randomized and clinical trial
• Grantee: Hamilton Augusto Roschel da Silva
• Support Opportunities: Regular Research Grants