Cognitive Patterns in School-Age Children with End-Stage Liver Disease

Stewart, Sunita M.; Campbell, Richard A.; McCALLON, Denise; Waller, David; Andrews, Walter S.

doi:10.1097/00004703-199210010-00003

Cited by 58 publications

(53 citation statements)

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“…There are some parallels between our study and those of adult rats (24 -26). From the perspective of brain development, 17 d of age in rats is equal to young childhood and 27-31 d of age in rats is equal to school ages in human beings (42); hence, this model mimics some core features of biliary atresia patients who are complicated with cognitive problems despite Kasai operation (9). We extend these results to the developing rats and provide the first evidence that melatonin can improve cognition in young rats with cholestasis.…”

Section: Discussionmentioning

confidence: 60%

“…Cognitive function is impaired in patients with liver disease (8,9) and in animal models of chronic liver failure (10). Liver failure can alter glutamatergic neurotransmission and in some associated signal transduction pathways, including the glutamate-nitric oxide-cGMP (11) and long-term potentiation (LTP) (12).…”

Section: Holestasis Is Encountered In a Variety Of Clinical Disordersmentioning

confidence: 99%

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Melatonin Ameliorates Bile Duct Ligation-Induced Systemic Oxidative Stress and Spatial Memory Deficits in Developing Rats

et al. 2009

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Bile duct ligation (BDL) induces primary biliary cirrhosis characterized by cholestasis, impaired liver function, and cognition. Young male Sprague-Dawley rats were used: rats underwent laparotomy without BDL ͓sham-control (SC) group͔; rats had restricted diets supply ͓diet-control (DC) group͔; rats underwent BDL for 2 wk (BDL group); BDL rats with melatonin (500 g/kg/d) intraperitoneally for 2 wk ͓melatonin (500 g/kg/d) (M500) group͔; and BDL rats with melatonin (1000 g/kg/d/intraperitoneally) for 2 wk ͓melatonin (1000 g/kg/d) (M1000) group͔. All the surviving rats were assessed for spatial memory and blood was tested for biochemical study. Liver, brain cortex, and hippocampus were collected for determination of malondialdehyde (MDA) and glutathione (GSH)/ oxidized glutathione (GSSG) ratios. BDL group rats had significantly higher plasma direct/total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), MDA values and higher liver MDA values and lower GSH/GSSG ratios when compared with SC group. In addition, BDL group rats had impaired spatial performance. After melatonin treatment, cholestatic rats' plasma MDA levels, liver MDA levels, and liver GSH/GSSG ratios approached to the values of SC group. Only high dose of melatonin improved spatial performance. Results of this study indicate cholestasis in the developing rats increase oxidative stress and cause spatial memory deficits, which are prevented by melatonin treatment.

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Section: Discussionmentioning

confidence: 60%

Section: Holestasis Is Encountered In a Variety Of Clinical Disordersmentioning

confidence: 99%

Melatonin Ameliorates Bile Duct Ligation-Induced Systemic Oxidative Stress and Spatial Memory Deficits in Developing Rats

et al. 2009

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“…IQs of children after heart transplantation are relative consistently reported to be 10-15 IQ points below nonclinical comparison groups (40,41). In children with biliary atresia, cognitive deficits can already be detected preoperatively (42,43). Given the starkly different etiologies and pathogenetic processes leading to organ failure in these diseases, the underlying neuropsychological and -biological mechanisms remain to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Performance in Pediatric Liver Transplant Recipients

Kaller

Langguth

Petermann

et al. 2013

American Journal of Transplantation

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To date, the course of cognitive development in children after liver transplantation (Ltx) is poorly understood. Cognitive performance, however, is crucial in all developmental stages and for educational achievement. This cross‐sectional single‐center study examined the prevalence of long‐term cognitive impairment in a cohort of 64 pediatric patients after Ltx. Median age at Ltx was 12 months. The revised Wechsler Intelligence Scale IV was administered to assess cognitive performance. Patients were compared with an age‐ and gender‐matched group of children without a chronic health condition. Liver transplanted children performed significantly worse in three of four cognitive domains as well as in the Total Intelligence Quotient (Total IQ) (p = 0.017 to p = 0.005). Liver transplant recipients showed substantially more “serious delays” (IQ < 70) compared to the reference group (9.4% vs. 4.7%). Children with a genetic–metabolic disease performed worse than the other groups in three of the four WISC Indices and in the Total IQ (p = 0.05 to p = 0.01). The strongest association was revealed between height at Ltx and Verbal Comprehension (R2 = 0.21), Perceptual Reasoning (R2 = 0.30), Working Memory (R2 = 0.23) and Total IQ (R2 = 0.25). Our results indicate a high impact of primary diagnosis and height percentile at Ltx even on children's long‐term cognitive performance.

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“…[1][2][3][4][5][6] Many of these patients do not manifest the symptoms and signs of hepatic encephalopathy, and their electroencephalograms and ammonia levels are often within normal limits. When cognitive impairment is detected in the absence of overt clinical signs or symptoms, it is often described as subclinical hepatic encephalopathy.…”

mentioning

confidence: 99%

Cognitive impairment in alcoholic and nonalcoholic cirrhotic patients

et al. 1999

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Cognitive impairment is common in patients with advanced liver disease. It has been suggested that patients with alcoholic liver disease (ALD) have more impaired cognition than nonalcoholics. The objective of this study was to characterize any differences in cognitive functions between alcoholic cirrhotic patients and non-alcoholic cirrhotic patients of similar age, education, and severity of liver disease. We assessed cognitive functions in 117 patients with alcoholic cirrhosis and 163 patients with nonalcoholic cirrhosis using a brief battery of neuropsychological tests. In addition, all patients had standard psychiatric examinations to assess the effect of the disease severity, alcoholism, anxiety, and depression on the test scores. The study showed a higher proportion of patients with cognitive impairment in the alcoholic group. Alcoholics performed poorly in tests of memory and motor speed compared with nonalcoholics, despite similar premorbid IQ and education. Because patients with alcoholic cirrhosis had more severe liver disease (Child-Pugh score 8.5 ؎ 2.2 vs. 7.6 ؎ 2.2, P ‫؍‬ .03) than nonalcoholics, the results were reanalyzed after adjusting for the linear effects of Child-Pugh score on cognitive test scores. We also used two-way analysis of variance to examine the interaction between Child class and alcoholism. Finally, the test scores were compared within each Child class. These analyses revealed no primary or interaction effect of alcoholism and confirmed that the differences in the test scores observed in alcoholics reflect the greater severity of their liver disease. The severity of cognitive impairment is similar in both alcoholic and non-alcoholic cirrhotic patients when adjusted for the severity of liver disease. (HEPATOLOGY 1999;30:1363-1367.)Cognitive impairment, detected by clinical observation and confirmed by neuropsychological tests, is common in patients with cirrhosis, irrespective of the etiology of liver disease.

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Cognitive Patterns in School-Age Children with End-Stage Liver Disease

Cited by 58 publications

References 0 publications

Melatonin Ameliorates Bile Duct Ligation-Induced Systemic Oxidative Stress and Spatial Memory Deficits in Developing Rats

Melatonin Ameliorates Bile Duct Ligation-Induced Systemic Oxidative Stress and Spatial Memory Deficits in Developing Rats

Cognitive Performance in Pediatric Liver Transplant Recipients

Cognitive impairment in alcoholic and nonalcoholic cirrhotic patients

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