The Effect of Bariatric Surgery on Peripheral Nerve Function and Axonal Regeneration

Peripheral neuropathy causes progressive injury to the longest nerves of the body, starting
in the toes, then progressing slowly up the leg. Neuropathy often causes pain, numbness, and
weakness if the feet and can lead to reduced mobility, foot ulcers, and even amputation. The
most common cause is diabetes, but work at the University of Utah finds that prediabetes and
other consequences of obesity, including abnormal cholesterol levels, may be associated with
neuropathy. Research has shown that these risk factors may damage nerves and interfere with
the ability of nerves to grow back after an injury.

This study aims to

1. characterize peripheral nerve function and cutaneous nerve structure in obese bariatric
surgery candidates;

2. evaluate peripheral nerve regeneration capacity (and other nerve function measures)
before and after bariatric surgery in obese subjects with no or mild neuropathy;

3. examine the relationship between ectopic lipid accumulation, lipotoxic mediators,
neuropathy and regeneration capacity in surgical candidates before and one year after
surgery.

Inclusion Criteria:

- Age 18-80 years old

- Subjects must fulfill criteria for bariatric surgery.

Exclusion Criteria:

- History of foot ulceration or neurogenic arthropathy

- Family history of non-diabetic neuropathy in a first-degree family member.

- Presence of any disease known to be associated with peripheral neuropathy including
but not limited to vitamin deficiency, toxin exposure, paraproteinemia, heavy alcohol
use, hepatitis C, HIV.

- Coumadin use.

- Inability to understand or cooperate with the procedures of the trial.

- Known history of sensitivity to capsaicin products.