title: Liver Fibrosis Predicts Cognitive Function Following Bariatric Surgery: A Preliminary Investigation.
abstract: OBJECTIVE
  Obesity is a well-established risk factor for poor neurological outcomes, and bariatric surgery has been shown to improve many aspects of cognitive function. Factors underlying improved cognition following surgery are not yet fully established. A recent study of bariatric surgery patients demonstrated lower preoperative alkaline phosphatase concentrations were linked to greater postoperative cognitive improvement, but this link has not been examined via liver biopsy. The current study examined postoperative cognitive function in individuals with and without fibrosis at the time of bariatric surgery. It expected that those with fibrosis would demonstrate poorer postoperative cognition.
  
  
  METHODS
  Thirty-six bariatric surgery patients underwent routine liver biopsy at the time of surgery and completed cognitive testing 1 month postoperatively.
  
  
  RESULTS
  Bariatric surgery patients with fibrosis demonstrated poorer performance on a task of executive function (maze errors, P = 0.01) and verbal memory (recognition memory, P = 0.01).
  
  
  CONCLUSIONS
  Bariatric surgery patients with fibrosis demonstrated poorer cognition following surgery, providing further evidence for the connection between liver disease and cognitive function. Future work examining mechanisms underlying bariatric postoperative cognitive changes should include examination of broader metabolic functions, particularly liver function.
authors.affiliation: Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.affiliation: Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.affiliation: Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Manderino
authors.affiliation: Behavioral Services, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA.|Department of Psychiatry and Psychology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Heinberg
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D050110:Bariatric Surgery; D015992:Body Mass Index; D003071:Cognition / Q000502:physiology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D011184:Postoperative Period
chemical_list: D000469:Alkaline Phosphatase