{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:00:06Z","timestamp":1790298006471,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Obesity"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Metabolic and bariatric surgery achieves durable weight loss and meaningful improvement in obesity\u2010related comorbidities yet carries a risk of neurological complications that remains under\u2010recognised in routine clinical practice. This systematic review, registered with PROSPERO (CRD42024591611) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses 2020 guidelines, searched MEDLINE, Embase, Emcare, CINAHL and Cochrane databases through September 2023 to evaluate the incidence, spectrum, timing, pathophysiology and management of post\u2010operative neurological complications. Twelve studies comprising over 5000 patients were included. Reported incidence ranged from 1.4% to 16%, with peripheral neuropathy the most frequent manifestation. Mononeuropathies, particularly carpal tunnel syndrome, were prominent in several cohorts, while central complications including Wernicke encephalopathy occurred less commonly but with considerably greater severity. Thiamine deficiency was the predominant aetiological factor. Onset varied from days to several years postoperatively, with early presentations typically compression\u2010related and later ones nutritionally mediated. Outcomes were generally favourable with early intervention, though severe or delayed cases were associated with persistent neurological deficits and occasional mortality. Neurological complications after bariatric surgery are heterogeneous and largely preventable, and structured post\u2010operative follow\u2010up with consistent adherence to nutritional supplementation remains central to reducing long\u2010term harm.<\/jats:p>","DOI":"10.1111\/cob.70102","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T01:30:38Z","timestamp":1785979838000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Neurological Impact of Metabolic and Bariatric Surgery: A Systematic Review of Post\u2010Operative Neuropathic and Non\u2010Neuropathic Complications"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4753-5524","authenticated-orcid":false,"given":"Srishruthi","family":"Thirumalai","sequence":"first","affiliation":[{"name":"University College London Medical School  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6028-0444","authenticated-orcid":false,"given":"G.","family":"Balamurugan","sequence":"additional","affiliation":[{"name":"Department of General Surgery South Tyneside and Sunderland NHS Foundation Trust  South Shields UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6304-8358","authenticated-orcid":false,"given":"Saurabh","family":"Jagdale","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology GEM Hospital and Research Institute  Coimbatore Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6688-4388","authenticated-orcid":false,"given":"Khadeija","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Royal Wolverhampton NHS Trust  Wolverhampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layla","family":"Sayyadi","sequence":"additional","affiliation":[{"name":"South Tyneside and Sunderland NHS Foundation Trust  Sunderland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreekrishna Kumar Ambalaparambil","family":"Vasu","sequence":"additional","affiliation":[{"name":"Department of General Surgery South Tyneside and Sunderland NHS Foundation Trust  South Shields UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Turner","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Foundation Trust  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Abuawwad","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal and Bariatric Surgery South Tyneside and Sunderland NHS Foundation Trust  Sunderland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066254"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600869"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066603"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-018-3450-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20461"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181884308"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000142038.43946.06"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.37.2.196"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.17712\/nsj.2016.3.20160039"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v8.i11.464"},{"issue":"4","key":"e_1_2_10_12_1","first-page":"769","article-title":"Neurological Complications in Patients Who Underwent Laparoscopic Sleeve Gastrectomy","volume":"17","author":"Eruyar E.","year":"2021","journal-title":"Surgery for Obesity and Related Diseases"},{"issue":"5","key":"e_1_2_10_13_1","first-page":"1476","article-title":"Peripheral Polyneuropathy in Patients With Obesity Scheduled for Bariatric Surgery","volume":"32","author":"Kim S. 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