Aberrant stability of brain functional architecture in cirrhotic patients with minimal hepatic encephalopathy

Cai, Li-Min; Shi, Jia-Yan; Dong, Qiu-Yi; Wu, Jin; Chen, Hua‐Jun

doi:10.1007/s11682-022-00696-9

Cited by 6 publications

(4 citation statements)

References 58 publications

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“…The proportion of men in each study was greater than that of women. The basic characteristics of the included studies are listed in Table 1 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). In addition, the included studies were high-quality literature.…”

Section: Basic Study Characteristics and The Results Of The Literatur...mentioning

confidence: 99%

Meta-analysis of the Correlation Between Cognitive Function and Imaging Features in Hepatic Encephalopathy

Lv,

Wu,

Wan

et al. 2023

Hepat Mon

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Objectives: This study aimed to systematically evaluate the correlation between cognitive function and brain imaging findings in patients with hepatic encephalopathy (HE). Methods: We searched PubMed, China National Knowledge Infrastructure, and Wanfang databases to obtain literature on cognitive function and the diagnosis of HE via brain imaging from the establishment of the databases to March 20, 2023. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. RevMan v. 5.3 software was used in the meta-analysis. Results: A total of 14 articles were included. The meta-analysis showed that digit symbol test (DST) scores and psychometric HE scores (PHES) were positively correlated with the imaging findings of the frontal lobe in patients with HE, with correlation coefficients of 0.49 (Z = 0.53; 95% confidence interval [CI]: 0.23 ~ 0.83) and 0.52 (Fisher’s Z: 0.58; 95% CI: 0.41 ~ 0.76), respectively. The number connection test-A reaction times were negatively correlated with the signal in the globus pallidus, with a correlation coefficient of -0.23 (Z = - 0.23; 95% CI: - 0.43~ - 0.03); DST scores were positively correlated with the signal in the globus pallidus, with a correlation coefficient of 0.45 (Z = 0.49; 95% CI: 0.29 ~ 0.69); and PHES were positively correlated with the mean peak of grey matter, with a correlation coefficient of 0.52 (Z = 0.57; 95% CI: 0.46 ~ 0.73). Conclusions: Imaging findings are related to the cognitive function of patients with HE. Therefore, they can be used to evaluate the cognitive function of these patients and promptly intervene in and prevent the progression of the disease.

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Section: Basic Study Characteristics and The Results Of The Literatur...mentioning

confidence: 99%

Meta-analysis of the Correlation Between Cognitive Function and Imaging Features in Hepatic Encephalopathy

Lv,

Wu,

Wan

et al. 2023

Hepat Mon

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“…MHE is the early stage of hepatic encephalopathy, of which the clinical manifestation is poor orientation. If left untreated, MHE can rapidly develop into hepatic encephalopathy in a very short time, with a very poor prognosis and high mortality [10]. MHE pathogenesis is complex and unclear.…”

Section: Discussionmentioning

confidence: 99%

Clinical study of probiotics combined with lactulose for minimal hepatic encephalopathy treatment

Shi

2023

European Journal of Gastroenterology &Amp; Hepatology

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Objective This study aimed to investigate the clinical effect of probiotics combined with lactulose for minimal hepatic encephalopathy (MHE) treatment. Methods A total of 88 patients with MHE were randomly divided into the control (n = 44) and combined groups (n = 44). The control group was treated with lactulose, while the combined group was treated with probiotics and lactulose. Serum ammonia, liver function [alanine aminotransferase (ALT) and aspartate transaminase (AST)], intestinal mucosal barrier markers [fatty acid-binding protein 2 (FABP2) and advanced glycation end-products (AGEs)] and number connection test A (NCT-A) and digit symbol test (DST) scores were tested and compared between the two groups. Results The post-treatment in the control and combined groups shows decreased serum ammonia levels, ALT and AST levels, FABP2 and AGEs levels and NCT-A score and increased DST score compared with pre-treatment, with a significant difference (P < 0.05). Post-treatment, the serum ammonia level, ALT and AST levels, FABP2 and AGEs levels, NCT-A score decreased and DST score increased in the combined group compared with the control group, with a significant difference (P < 0.05). Conclusion Probiotics can promote lactulose in MHE treatment.

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“…The dynamic characteristics of brain activity, commonly measured by dALFF, reflect intrinsic brain function during mental and cognitive processes ( Wang et al, 2016 ; Kucyi et al, 2017 ) and have recently been widely used as neuroimaging markers to deepen knowledge about the neural mechanisms underlying various neurological and psychiatric disorders ( Kim et al, 2017 ; Li et al, 2018 ). Although the cognitive deficits in MHE were confirmed to be associated with abnormal dynamic functional connectivity networks ( Chen et al, 2017 ; Cheng et al, 2021 ; Cai et al, 2022 ), whether the time-varying patterns of regional intrinsic brain activity are aberrant remains unknown. Compared to dynamic functional connectivity, dynamic brain activity can be presented with respect to captures fluctuation in spatial variability and strength using first-level statistics ( Fu et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Changes in dynamic and static brain fluctuation distinguish minimal hepatic encephalopathy and cirrhosis patients and predict the severity of liver damage

Jiang

Liu

et al. 2023

Front. Neurosci.

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PurposeMinimal hepatic encephalopathy (MHE) is characterized by mild neuropsychological and neurophysiological alterations that are not detectable by routine clinical examination. Abnormal brain activity (in terms of the amplitude of low-frequency fluctuation (ALFF) has been observed in MHE patients. However, little is known concerning temporal dynamics of intrinsic brain activity. The present study aimed to investigate the abnormal dynamics of brain activity (dynamic ALFF; dALFF) and static measures [static ALFF; (sALFF)] in MHE patients and to strive for a reliable imaging neuromarkers for distinguishing MHE patients from cirrhosis patients. In addition, the present study also investigated whether intrinsic brain activity predicted the severity of liver damage.MethodsThirty-four cirrhosis patients with MHE, 28 cirrhosis patients without MHE, and 33 age-, sex-, and education-matched healthy controls (HCs) underwent resting-state magnetic resonance imaging (rs-fMRI). dALFF was estimated by combining the ALFF method with the sliding-window method, in which temporal variability was quantized over the whole-scan timepoints and then compared among the three groups. Additionally, dALFF, sALFF and both two features were utilized as classification features in a support vector machine (SVM) to distinguish MHE patients from cirrhosis patients. The severity of liver damage was reflected by the Child–Pugh score. dALFF, sALFF and both two features were used to predict Child–Pugh scores in MHE patients using a general linear model.ResultsCompared with HCs, MHE patients showed significantly increased dALFF in the left inferior occipital gyrus, right middle occipital gyrus, and right insula; increased dALFF was also observed in the right posterior lobe of the cerebellum (CPL) and right thalamus. Compared with HCs, noMHE patients exhibited decreased dALFF in the right precuneus. In contrast, compared with noMHE patients, MHE patients showed increased dALFF in the right precuneus, right superior frontal gyrus, and right superior occipital gyrus. Furthermore, the increased dALFF values in the left precuneus were positively associated with poor digit-symbol test (DST) scores (r = 0.356, p = 0.038); however, dALFF in the right inferior temporal gyrus (ITG) was negatively associated with the number connection test–A (NCT-A) scores (r = -0.784, p = 0.000). A significant positive correlation was found between dALFF in the left inferior occipital gyrus (IOG) and high blood ammonia levels (r = 0.424, p = 0.012). Notably, dALFF values yielded a higher classification accuracy than sALFF values in distinguishing MHE patients from cirrhosis patients. Importantly, the dALFF values predicted the Child–Pugh score (r = 0.140, p = 0.030), whereas sALFF values did not in the current dataset. Combining two features had high accuracy in classification in distinguishing MHE patients from cirrhotic patients and yielded prediction in the severity of liver damage.ConclusionThese findings suggest that combining dALFF and sALFF features is a useful neuromarkers for distinguishing MHE patients from cirrhosis patients and highlights the important role of dALFF feature in predicting the severity of liver damage in MHE.

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Aberrant stability of brain functional architecture in cirrhotic patients with minimal hepatic encephalopathy

Cited by 6 publications

References 58 publications

Meta-analysis of the Correlation Between Cognitive Function and Imaging Features in Hepatic Encephalopathy

Meta-analysis of the Correlation Between Cognitive Function and Imaging Features in Hepatic Encephalopathy

Clinical study of probiotics combined with lactulose for minimal hepatic encephalopathy treatment

Changes in dynamic and static brain fluctuation distinguish minimal hepatic encephalopathy and cirrhosis patients and predict the severity of liver damage

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