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Abstract

Minimal hepatic encephalopathy (HE) is characterized by a decrease of psychomotor speed, and deficits in visual perception, visuo-spatial orientation, and visuo-constructive abilities. Attention deficits have also been proposed to be part of the syndrome. Several attempts were made in the past to elaborate suitable psychometric means for the assessment of minimal HE. However, there is still no "gold standard" for the diagnosis of minimal HE. We recently evaluated the so called "PSE-Test" for the assessment of minimal HE, a test battery which does not include a test predominantly aimed at the assessment of attention. We therefore presented a battery of attention tests in addition to the PSE-Test to a group of cirrhotics without clinical signs of HE compared to a healthy control group matched for age and education to determine whether the addition of special attention tests would increase the diagnostic sensitivity of the PSE-Test. It was shown that the patients with a pathological PSE-Test result differed significantly from controls in all attention tests applied, while the patients with normal PSE-Test results achieved attention test results similar to that of the controls. Thus, the PSE-Test results represent attention deficits as well as deficits in motor skills, visuo-spatial orientation, and visual construction.

Altered Regional Homogeneity in the Development of Minimal Hepatic Encephalopathy: A Resting-State Functional MRI Study

“…The cuneus is considered to be centers of visual processing and inhibitory control [33]. Defects in visual processing and executive functions such as response inhibition in patients with MHE have been described in many previous studies [2], [34]. In this study, we found that regional coherence or synchronization in the bilateral cuneus was decreased in MHE patients while not in non-HE patients, indicating the cuneus might be a specific marker for MHE.…”

Cognitive assessment of patients with minimal hepatic encephalopathy in Brazil

“…Moreover, for selective attention to function properly, it needs the activity of the dorsolateral pre-frontal cortex, the parietal cortex, the frontal occulomotor fields, the superior colliculus, and the pulvinar of the thalamus (Weissenborn et al 2005). Weissenborn et al (2001a) and Amodio et al (2005, 2010) previously described deficits in selective attention in cirrhotic patients, although no mention was made whether patients treated with interferon had been excluded. In the present study, we found no statistically significant difference between cirrhotic patients and the controls.…”

Classification of Cirrhotic Patients with or without Minimal Hepatic Encephalopathy and Healthy Subjects Using Resting-State Attention-Related Network Analysis

“…Attention deficit is an early and key characteristic of MHE [3], [4], [5], [6], which is associated with patients’ falls and can result in impaired driving skills [7] and increased risk of motor vehicle accidents [8]. However, the neuropathological mechanisms underlying attention deficit in MHE are not completely understood so far, although it is reported that MHE patients show dysfunction in various attention subsystems [3], [4].…”