Frontal assessment battery: A tool for screening minimal hepatic encephalopathy?

Abstract

AIMTo apply the Frontal Assessment Battery to cirrhotic patients with or without overt hepatic encephalopathy (OHE) and controls.METHODSThe frontal assessment battery (FAB) was applied to 87 patients with liver cirrhosis (16 with and 71 without OHE) and 40 control subjects without cirrhosis treated at the alcohol and liver outpatient clinics and the gastroenterology ward of the Cassiano Antônio de Moraes University Hospital (Hospital Universitário Cassiano Antônio de Moraes - HUCAM), Espírito Santo, Brazil.RESULTSThe average FAB score was lower for the cirrhotic than for the non-cirrhotic patients (10.6 ± 3.67 vs 12.25 ± 2.72, P = 0.015). The FAB score was lower for the cirrhotic patients with OHE than for the patients without OHE (8.25 ± 4.55 vs 11.14 ± 3.25, P = 0.027). The total FAB score was lower for the cirrhotic patients without OHE than for the non-cirrhotic patients, although this difference was not significant (11.14 ± 3.25 vs 12.25 ± 2.72, P = 0.067). Nevertheless, the difference in the scores on the subtest that assessed the ability to inhibit a response previously conditioned to a stimulus was significant (1.72 ± 0.93 vs 2.2 ± 0.85, P = 0.011).CONCLUSIONThe present study indicates that the FAB is a promising tool for outpatient minimal HE screening and the assessment of HE severity.

Retracted: Efficacy of different drugs in the treatment of minimal hepatic encephalopathy: A network meta‐analysis involving 826 patients based on 10 randomized controlled trials

“…4 In addition, the cognitive deficits caused by MHE negatively impact the social and occupational lives of the patients and thus impairing their quality of life 5 and are accompanied with a higher risk of accidents. 6 MHE requires specialized testing for diagnosis as it cannot be diagnosed on standard clinical examination. 7 The medical treatments of MHE that were searched for the meta-analysis were mainly lactulose, probiotics, rifaximin, acetyl-L-carnitine (ALC), and L-Ornithine L-aspartate (LOLA).…”

“…Sleep disturbances including excessive day time sleepiness and impaired sleep quality are common in patients with cirrhosis related MHE, which leads to neuropsychiatric impairment, which can highly affect health related quality of life (HRQOL) 4. In addition, the cognitive deficits caused by MHE negatively impact the social and occupational lives of the patients and thus impairing their quality of life5 and are accompanied with a higher risk of accidents 6. MHE requires specialized testing for diagnosis as it cannot be diagnosed on standard clinical examination 7.…”