Aims and objectives
Patients suffering from cirrhosis are at high risk to develop severe neuropsychiatric symptoms,
subsumed as hepatic encephalopathy (HE) .
HE is an important complication of both acute and chronic liver diseases .
Manifestations of HE encompass altered level of consciousness,
intellectual impairment and personality changes [3,4].
In a multimodal approach,
we investigated cognition and structural brain changes in a well-characterized cohort of liver cirrhotic patients with and without HE.
Methods and materials
Subjects and procedure
In this study,
40 cirrhotic patients were recruited with different grades of HE before getting Transjugular Intrahepatic Portosystemic Shunt (TIPS).
Laboratory parameters were obtained from all patients to assess the severity of liver disease.
The functional liver status was assessed by Child Pugh score ,
and risk for mortality evaluated by MELD (model of end stage liver disease) score.
HE was diagnosed by clinical examination using the West Haven Criteria [6,7].
Forty age- and sex-matched healthy controls without any medical history of...
liver cirrhosis patients presented significantly impaired executive functions and attention (Fig.
1) independent from the etiology of liver cirrhosis (means: z= -1.49 (SD 1.19)).
Table 2 shows the neuropsychological performance of HE subgroups.
Compared to Non-HE patients,
patients with HE,
regardless of the HE-state (MHE or HE1) performed worse in the TMT-B (MHE: p =0.003,
logical memory (MHE: p=0.026,
HE1: p=0.011) and TAP divided attention tests (MHE: p=0.049,
HE-states themselves (MHE and HE1) did not...
DTI and neuropsychometric tests are appropriate methods to describe white matter alterations and attention/executive dysfunction in liver cirrhosis patients with and without HE,
pointing to the value of multimodal approach after TIPS for monitoring the cognitive development of patients.
Institute of Diagnostic and Interventional Radiology,
Pediatric Radiology and Neuroradiology,University Medical Center Rostock
phone: +49 (0)381/494-9262
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