Cognitive Changes and Brain Volume Reduction in Patients with Nonalcoholic Fatty Liver Disease

Abstract

Studies of psychological condition of patients suffering from nonalcoholic fatty liver disease are rather equivocal about the results: while some claim that NAFLD patients suffer from anxiety and depression more than non-NAFLD controls, others do not withstand those findings. Lower cognitive potentials have also been reported, both in patient related and in animal model-based investigations, and correlated with assessed brain tissue changes. We hypothesized that NAFLD, as a condition, affects the brain tissue and, subsequently, the cognitive state. So we compared findings in 40 NAFLD positive and 36 NAFLD negative patients and correlated their brain tissue volumes with the results of Montreal Cognitive Assessment (MoCA) test. Binomial logistic regression verified the influence of NAFLD state leading to lower cognitive potentials: odds ratio 0.096; 95% confidence interval (CI) 0.032–0.289; p < 0.001. Patients with NAFLD had a greater risk to suffer from the cognitive impairment and depression: RR = 3.9; 95% CI 1.815–8.381; p = 0.0005 and RR = 1.65; 95% CI 1.16–2.36; p = 0.006. NAFLD significantly influenced the cognitive deficit and tissue volume reduction and patients suffering from NAFLD had about four times higher risk of having a cognitive impairment.

Depression and Cognitive Impairment—Extrahepatic Manifestations of NAFLD and NASH

“…In combination with the reduced gray and white volumes, these authors found an increase of lateral ventricles volumes, justifying the constant total brain volume in presence of different cognitive situations between the tested group. The main conclusion achieved by this study is that patients with NAFLD have a risk four times higher of manifesting lower cognitive abilities and depleted cognitive performance and deficit, and also confirmed the higher concentration of AST in NAFLD patients with cognitive deficit [15]. The correlation between higher levels of AST and ALT and poorer cognitive function, especially in visuospatial memory, was also supported by a recent population-based study conducted by An and collaborators [24].…”

“…They found a significant reduction of white and gray brain volumes and an increased volume of lateral ventricles, with respect to healthy patients. This ulterior remark suggests a higher risk of depression in NAFLD-diagnosed patients [15].…”

Изменения Сосудов Головного Мозга У Пациентов С Неалкогольной Жировой Болезнью Печени И Нарушением Углеводного Обмена

“…Various studies paid attention to psychological status, cognitive impairment, as well as their association with changes in the structure of the brain (with a decrease in the volume of white matter) and the severity of fibrosis at NAFH (B. Filipović et al, 2018) [13]. It is believed that cerebral hemodynamics due to disruptions in the microcirculation can lead to structural changes in the brain that underlie cognitive impairment (L.B.…”

Нейровегетативные И Когнитивные Нарушения У Пациентов С Неалкогольной Жировой Болезнью Печени И Сахарным Диабетом 2 Типа

“…There are researches studying the psychological status in patients with NAFLD, but they are prevalently directed to detect a depression in these patients, and the obtained results are definitive. In conclusion, the psychological status of patients with NAFLD stays still ambiguous [10], especially in type 2 diabetes mellitus, obesity, etc.…”