Bariatric Surgery Induces White and Grey Matter Density Recovery in the Morbidly Obese: A Voxel-Based Morphometric Study

Research output: Contribution to journalArticle


  • Jetro J. Tuulari
  • Henry K. Karlsson
  • Olli Antikainen
  • Jussi Hirvonen
  • Tam Pham
  • Paulina Salminen
  • Mika Helmiö
  • Riitta Parkkola
  • Pirjo Nuutila
  • Lauri Nummenmaa

Research units

  • Turku PET Centre
  • University of Turku


Obesity is associated with lowered brain's grey (GM) and white matter (WM) density as measured by voxel-based morphometry (VBM). Nevertheless, it remains unknown whether obesity has a causal influence on cerebral atrophy. We recruited 47 morbidly obese subjects (mean BMI=42.2, SD=4.0, 42 females and five males) eligible for bariatric surgery and 29 non-obese subjects (mean BMI=23.2, SD=2.8, 23 females and six males) served as controls. Baseline scans were acquired with T1-weighted magnetic resonance imaging (MRI) at 1.5 Tesla; obese participants were scanned again six months after the surgery. Local GM and WM densities were quantified using VBM. Full-volume analyses were used for comparing baseline between-group differences as well as the effects of surgery-induced weight loss in the morbidly obese. Metabolic variables were used in linear models to predict WM and GM densities. Obese subjects had initially lower GM densities in widespread cortical areas including frontal, parietal, and temporal regions as well as insulae. Lower WM densities were observed throughout the WM. Bariatric surgery and concomitant weight loss resulted in global increase in WM density. Grey matter increase was limited to occipital and inferior temporal regions. Metabolic variables were associated with brain densities. We conclude that weight loss results in global recovery of WM as well as local recovery of grey matter densities. These changes likely reflect improved brain tissue integrity.


Original languageEnglish
Pages (from-to)3745–3756
Number of pages12
JournalHuman Brain Mapping
Issue number11
Publication statusPublished - Oct 2016
MoE publication typeA1 Journal article-refereed

    Research areas

  • Bariatric surgery, Obesity, Structural MRI, Voxel-based morphometry, Weight loss

ID: 6964286