title: Executive control circuitry differentiates degree of success in weight loss following gastric-bypass surgery.
abstract: OBJECTIVE
  While overall success rates of bariatric surgery are high, approximately 20% of patients either regain or never lose the expected amount of weight. The purpose of this study was to determine whether, after gastric-bypass surgery, the degree of weight loss can be differentiated based on the neural response to food cues.
  
  
  METHODS
  In this functional MRI study, 31 post-surgical patients viewed food and neutral images in two counterbalanced runs during which they were either instructed to "crave" or to "resist" craving. The neural response to food cues was assessed within and between runs for all participants, and further analyzed between more successful (n = 24) and less successful (n = 7) groups. More successful was defined by meeting 50% excess weight loss.
  
  
  RESULTS
  Overall, instructions to "crave" elicited significant activity in the dorsomedial prefrontal cortex (PFC) whereas "resist" elicited significant activity in the dorsolateral PFC (DLPFC). Between groups there was no brain difference when instructed to "crave." The more successful participants however had significantly more activity in the DLPFC when instructed to "resist."
  
  
  CONCLUSIONS
  These findings suggest that the ability to mobilize neural circuits involved in executive control post-gastric-bypass surgery may be a unique component of successful outcome post-surgery.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Goldman
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Canterberry
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.|Department of Anesthesiology and Perioperative Medicine, Charleston, South Carolina, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Borckardt
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.affiliation: Department of Surgery Department of Neurology and Radiology Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: T Karl
authors.initials: TK
authors.lastname: Byrne
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.|Department of Surgery Department of Neurology and Radiology Medical University of South Carolina, Charleston, South Carolina, USA.|Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: George
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: O'Neil
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Charleston, South Carolina, USA.
authors.forename: Colleen A
authors.initials: CA
authors.lastname: Hanlon
mesh_terms: D000328:Adult; D000368:Aged; D056344:Executive Function / Q000502:physiology*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009415:Nerve Net / Q000502:physiology*; D009767:Obesity, Morbid / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult