Identifying minimal hepatic encephalopathy in cirrhotic patients by measuring spontaneous brain activity

Chen, Hua-Jun; Zhang, Ling; Jiang, Longfeng; Chen, Qiu-Feng; Li, Jun; Shi, Haibin

doi:10.1007/s11011-016-9799-9

Cited by 16 publications

(12 citation statements)

References 43 publications

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“…Severity-dependent changes in FC were observed in the left precentral gyrus confirming previous studies showing significantly decreased amplitude of low frequency fluctuation in the precentral gyrus among patients with CHE 45 . Therefore, the precentral gyrus may be important and discriminative brain regions responsible for CHE development 51 .…”

Section: Discussionmentioning

confidence: 99%

Altered cognitive control network is related to psychometric and biochemical profiles in covert hepatic encephalopathy

Tsai¹,

Wang³

et al. 2019

Sci Rep

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The cognitive control network (CCN) is a network responsible for multiple executive functions, which are impaired in covert hepatic encephalopathy (CHE). We aimed to use functional connectivity (FC) magnetic resonance imaging to test the hypothesis that CHE manifested with disconnection within the CCN, which is associated with impaired neuropsychiatric and biochemical profiles. CHE was detected with abnormally low psychometric hepatic encephalopathy scores (PHES) (total cut-off score <−4). Two seeds in the dorsal anterior cingulate cortex (dACC) and the dorsolateral prefrontal cortex (DLPFC) were used to calculate the FC map within the CCN. Pearson correlation analysis was performed between the CCN and psychometric, biochemical profiles including ammonia, Interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Eighteen CHE, 36 non-HE (NHE) cirrhotic patients and 36 controls were studied. Significant differences in FC were noted among groups, which revealed CHE patients had a lower FC in the bilateral lateral occipital cortex (seed in the bilateral dACC) and in the right lateral occipital and precuneus cortices (seed in the left DLPFC) (P < 0.05, corrected) compared with NHE. Progressively decreased FC in the left precentral gyrus within the CCN was noted from control, NHE to CHE. PHES positively and biochemistry negatively correlated with FC in the CCN. In conclusion, CHE patients showed aberrant FC within the CCN which is correlated with both cognitive dysfunction and biochemical profiles. Ammonia and pro-inflammatory cytokines may contribute to the occurrence of aberrant connectivity. Impaired FC within the CCN may serve as a complementary biomarker for CHE.

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Section: Discussionmentioning

confidence: 99%

Altered cognitive control network is related to psychometric and biochemical profiles in covert hepatic encephalopathy

Tsai¹,

Wang³

et al. 2019

Sci Rep

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“…Chen et al demonstrated that the amplitude of low frequency fluctuation (ALFF) values within six regions of interest (ROIs) correlated with PHES in cirrhosis patients. The ROIs contains the posterior cingulate cortex/precuneus, bilateral medial frontal cortex/anterior cingulate cortex, right lingual gyrus, the left precentral and postcentral gyrus, inferior/superior parietal and middle frontal gyrus lobule (Chen et al 2016 ). Zhong et al also found that patients with MHE had significant decreased ALFF (Zhong et al 2016 ).…”

Section: Diagnosis Of Mhe: Cognitive Evaluationmentioning

confidence: 99%

Cognition-tracking-based strategies for diagnosis and treatment of minimal hepatic encephalopathy

et al. 2020

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Minimal hepatic encephalopathy (MHE), which shows mild cognitive impairment, is a subtle complication of cirrhosis that has been shown to affect daily functioning and quality of life. However, until 2014, relevant guidelines do not give much attention to the diagnosis and treatment of MHE, resulting in patients being ignored and denied the benefits of treatment. In this review, we summarize recent cognition-based research about (1) alteration of nerve cells, including astrocytes, microglial cells and neurons, in mild cognitive impairment in MHE; (2) comparison of methods in detecting cognitive impairment in MHE; and (3) comparison of methods for therapy of cognitive impairment in MHE. We hope to provide information about diagnosis and treatment of cognitive impairment in patients with MHE.

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“…Spontaneous brain activity can also be measured by examining the amplitude of low-frequency fluctuation (ALFF) in the MRI 101 . It can be used as a biomarker for the detection of HE 101 .…”

Section: Recent Advances In the Diagnosis Of Hepatic Encephalopathymentioning

confidence: 99%

“…Spontaneous brain activity can also be measured by examining the amplitude of low-frequency fluctuation (ALFF) in the MRI 101 . It can be used as a biomarker for the detection of HE 101 . Upcoming research focuses on ALFF in combination with blood oxygenation level-dependent functional MRI, creating new opportunities for the diagnosis of HE 102 .…”

Section: Recent Advances In the Diagnosis Of Hepatic Encephalopathymentioning

confidence: 99%

Recent advances in hepatic encephalopathy

2017

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Hepatic encephalopathy describes the array of neurological alterations that occur during acute liver failure or chronic liver injury. While key players in the pathogenesis of hepatic encephalopathy, such as increases in brain ammonia, alterations in neurosteroid levels, and neuroinflammation, have been identified, there is still a paucity in our knowledge of the precise pathogenic mechanism. This review gives a brief overview of our understanding of the pathogenesis of hepatic encephalopathy and then summarizes the significant recent advances made in clinical and basic research contributing to our understanding, diagnosis, and possible treatment of hepatic encephalopathy. A literature search using the PubMed database was conducted in May 2017 using “hepatic encephalopathy” as a keyword, and selected manuscripts were limited to those research articles published since May 2014. While the authors acknowledge that many significant advances have been made in the understanding of hepatic encephalopathy prior to May 2014, we have limited the scope of this review to the previous three years only.

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Identifying minimal hepatic encephalopathy in cirrhotic patients by measuring spontaneous brain activity

Cited by 16 publications

References 43 publications

Altered cognitive control network is related to psychometric and biochemical profiles in covert hepatic encephalopathy

Altered cognitive control network is related to psychometric and biochemical profiles in covert hepatic encephalopathy

Cognition-tracking-based strategies for diagnosis and treatment of minimal hepatic encephalopathy

Recent advances in hepatic encephalopathy

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