Evidence mapPaperPMID 40878593Full record

ArticleDiabetes, obesity & metabolism2025

Neural pathways to bariatric success: What explainable AI reveals that conventional fMRI methods may miss.

Adrian Falkowski, Magdalena Szwed, Johanna Seitz-Holland, Jakub Wojtasik, Maciej Michalik, Marek Kubicki, Krzysztof Szwed

Abstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Adrian FalkowskiFaculty of Mathematics and Computer Science, Nicolaus Copernicus University, Toruń, Poland.
Magdalena SzwedDepartment of Clinical Neuropsychology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.ORCID https://orcid.org/0000-0002-0673-2910
Johanna Seitz-HollandDepartment of Psychiatry, Mass General Brigham, Harvard Medical School, Sommerville, Massachusetts, USA.
Jakub WojtasikDoctoral School of Social Sciences, Nicolaus Copernicus University, Toruń, Poland.
Maciej MichalikClinic of General and Minimally Invasive Surgery, Jan Biziel University Hospital No. 2 in Bydgoszcz, Poland.
Marek KubickiDepartment of Psychiatry, Mass General Brigham, Harvard Medical School, Sommerville, Massachusetts, USA.
Krzysztof SzwedDepartment of Clinical Neuropsychology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.

Funding

BBRF Young Investigator grant (funded by Mary and John Osterhaus and the Brain & Behavior Research Foundation)Nicolaus Copernicus University 90-SIDUB.6102.24.2022.DB3NIMH NIH HHS K99 MH131850NIMH NIH HHS K99MH131850
6 · The paper itself

Abstract

aimsMetabolic-bariatric surgery (MBS) remains a cornerstone of obesity treatment, yet 15%-30% of patients fail to achieve its intended benefits. Existing clinical and biochemical markers offer limited value in identifying who will respond favourably to this intervention. We hypothesize that the long-term success of MBS is influenced by individual differences in preoperative brain function. MATERIALS AND

methodsWe collected presurgical resting-state fMRI data from 45 patients undergoing MBS, with the aim of identifying neural patterns associated with achieving at least 50% excess weight loss 12 months post-surgery. The data were analysed using both conventional methods and a high-powered machine learning approach. For the latter, we trained five predictive models on functional connectivity, regional brain activity, and clinical variables. We then applied SHapley Additive exPlanations (SHAP) to the best-performing model to interpret its internal logic, thereby revealing the neural features most strongly linked to treatment success.

resultsConventional methods proved inadequate for this study. A multilayer perceptron model, trained exclusively on functional connectivity data, achieved a noteworthy AUC of 0.85. Its SHAP analysis revealed key neural circuits in the postcentral gyrus, dorsolateral prefrontal cortex, and angular gyrus-regions associated with interoception, executive control, and social-cognitive processes such as theory of mind.

conclusionExplainable AI-powered fMRI analysis uncovered subtle neural patterns that conventional methods failed to detect. These findings suggest that a patient's "neural readiness" for MBS may extend beyond self-regulatory circuits. It may also depend on their capacity to perceive and interpret internal bodily signals and to process emotional information-both personal and social.

Indexed as

Bariatric SurgeryBrainMagnetic Resonance ImagingNeural PathwaysObesityObesity, MorbidAdultFemaleHumansMachine LearningMaleMiddle AgedTreatment OutcomeWeight Lossbariatric surgerycohort studyobesity careobesity therapyweight management

Identifiers

PMID40878593
PMCPMC12515754

What Socratic holds

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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 Socratic graph.