Evidence map›Paper›PMID 40875171›Full record

Observational studyObesity surgery2025

Sustained Improvement of Cognition, Mood and Plasma Markers Three Years After Metabolic Bariatric Surgery. The BARICO Study.

Emma Custers, Debby Vreeken, Robert Kleemann, Roy P C Kessels, Esmee Tijman Op Smeijers, Joachim Høg Mortensen, Martine C Morrison, Eveline Gart, Maximilian Wiesmann, Eric J Hazebroek and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Obesity surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Effects of obesity on brain health and cognition.Nature reviews. Neurology · 2026
    Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Emma CustersDepartment of Medical Imaging, Anatomy, Radboud Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands.
Debby VreekenDepartment of Medical Imaging, Anatomy, Radboud Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands.
Robert KleemannDepartment of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, The Netherlands.
Roy P C KesselsCentre of Excellence for Korsakoff and Alcohol-related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.
Esmee Tijman Op SmeijersDepartment of Medical Imaging, Anatomy, Radboud Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands.
Joachim Høg MortensenBiomarkers & Research, Nordic Bioscience A/S, Herlev, Denmark.
Martine C MorrisonDepartment of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, The Netherlands.
Eveline GartDepartment of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, The Netherlands.
Maximilian WiesmannDepartment of Medical Imaging, Anatomy, Radboud Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands.
Eric J HazebroekDepartment of Bariatric Surgery, Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands.
Amanda J KiliaanDepartment of Medical Imaging, Anatomy, Radboud Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands. amanda.kiliaan@radboudumc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe primary aim of this study is to investigate the impact of MBS induced weight loss on cognition, and secondary investigate the impact of this weight loss on adipokines, inflammatory factors, vascular markers, mood and physical activity three years after MBS.

methodsThis observational study assessed data from 107 patients with severe obesity (aged 35 to 55 years) from the BARICO (BAriatric surgery Rijnstate and Radboudumc neuroImaging and Cognition in Obesity) study, eligible for Roux-en-Y gastric bypass. Data were collected before, and at 6, 24 and 36 months after MBS. The primary outcome was long-term cognitive improvement, assessed using the 20% change index, which compares postoperative to preoperative test scores across cognitive domains. Mood and physical activity were assessed using the Beck Depression Inventory (BDI) and the Baecke questionnaire, respectively.

resultsIn total, 107 participants (mean [SD] age, 46.8 [5.6] years; 91 [85%] female) were included. Three years after MBS, global cognition was at least 20% higher in 38.6% (n = 39) of the participants. Compared to baseline, inflammatory factors, leptin, matrix metalloproteinase-9 (MMP-9), and apolipoprotein A1 (ApoA1) levels remained lower (median [IQR] C-reactive protein: 4.51 [2.96-8.35] vs 0.60 [0.30-1.30] µg/ml; p < 0.001; serum amyloid-alpha: 6.94 [4.80-15.16] vs 3.70 [2.30-6.00] µg/ml; p < 0.001; leptin: 64.6 [50.95-85.91] vs 18.95 [11.05-33.38] pg/ml; p < 0.001; MMP-9: 22.2 [18.2-31.3] vs 16.8 [13.2-23.1] ng/ml; p < 0.001; ApoA1: 535.47 ± 150.94 (SD) vs 261.33 ± 112.75 (SD) µg/ml; p < 0.001), whereas adiponectin (2.20 [1.70-2.75] vs 4.80 [3.50-7.00] µg/ml; p < 0.001) and angiopoietin-1 (ANGPT-1: 14.3 [10.4-22.55] vs 26.15 [21.2-33.9] ng/ml; p < 0.001) levels remained higher three years after MBS. Additionally, depressive symptoms remained low three years after MBS (median [IQR] BDI score: 9 [5.25-13] vs 4 [2-7]; p < 0.001), whereas physical activity returned to baseline. CONCLUSION AND RELEVANCE: Three years after MBS, weight loss remains associated with improved cognition and general health, evidenced by lower blood pressure, lower medication use, less systemic inflammation, lower leptin and higher adiponectin levels, and improved vascular markers.

Indexed as

AffectBariatric SurgeryCognitionGastric BypassObesity, MorbidWeight LossAdultApolipoprotein A-IBiomarkersC-Reactive ProteinExerciseFemaleHumansLeptinMaleMiddle AgedApolipoprotein A-IBiomarkersC-Reactive ProteinLeptinCognitive functionLong-term outcomesMetabolic bariatric surgeryObesityPlasma biomarkers

Identifiers

PMID40875171
PMCPMC12457502

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.