Inhibitory Control Test Is a Simple Method to Diagnose Minimal Hepatic Encephalopathy and Predict Development of Overt Hepatic Encephalopathy

Bajaj, Jasmohan S.; Saeian, Kia; Verber, Matthew D.; Hischke, Darrell; Hoffmann, Raymond G.; Franco, José; Varma, Rajesh; Rao, Stephen M.

doi:10.1111/j.1572-0241.2007.01048.x

Cited by 142 publications

(154 citation statements)

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“…In the healthy control group, a score of $14 ICT lures was seen in 31 of 95 (32.6%) subjects. Using the cut-off of >5 ICT lures proposed by Bajaj et al, 19,20 we observed that the number of healthy patients showing altered ICT increased to 81 of 95 (88.4%). Lure weighted by target accuracy or sum of PHES score and ICT lures did not further improve the diagnostic accuracy of PHES alone.…”

Section: Prevalence Of Minimal Hepatic Encephalopathymentioning

confidence: 89%

“…19,20 Though ICT is easy to administer in an outpatient setting and showed good test-retest reliability, it did not have external validity for MHE because it did not predict either survival or number of the episodes of OHE on follow-up. Thus the ICT provided cognitive measures which were not up to the recommended diagnostic standards for cognitive investigation of MHE.…”

Section: Discussionmentioning

confidence: 99%

“…Lately, computerized tests directed toward the study of the cognitive domains have been used for the diagnosis of MHE. The ICT, [19][20][21] together with the scan test 32,33 and possibly the Cognitive Drug Research battery 34 are the only computerized tests that have been expressly applied to patients with cirrhosis based on known cognitive features of MHE. ICT is a test of attention and response inhibition and has been proposed as a simple diagnostic tool for diagnosis of MHE with a high sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

“…The results were expressed as number and percent of incorrect lure responses, correct lure inhibitions, correct target responses, and incorrect target misses. 19,20 Test-retest Reliability A subgroup of 25 controls agreed to undergo ICT for a second time 4 weeks after the first evaluation to assess test-retest reliability.…”

Section: Inhibitory Control Testmentioning

confidence: 99%

“…It has been validated for the diagnosis and follow-up of MHE in the USA, and has been found to be a sensitive and reliable test. 19,20 However, it requires that the subject be familiar with the use of computers and needs to be validated in other populations as well. Amodio et al 21 assessed the efficacy of ICT compared with diagnostic standards and found that ICT is not useful for the diagnosis of MHE, unless adjusted by target accuracy.…”

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confidence: 99%

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Inhibitory Control Test for the Detection of Minimal Hepatic Encephalopathy in Patients with Cirrhosis of Liver

Taneja¹,

Dhiman²,

Khatri³

et al. 2011

Journal of Clinical and Experimental Hepatology

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Background & aims: Minimal hepatic encephalopathy (MHE) has significant impact on future clinical outcomes, such as occurrence of overt HE (OHE) and survival in patients of cirrhosis. In the absence of a 'gold standard', psychometric hepatic encephalopathy score (PHES) is widely used for the diagnosis of MHE. This cross-sectional and prospective study was carried out to determine the usefulness of inhibitory control test (ICT) for the diagnosis of MHE. Methods: One hundred and two patients with cirrhosis and without a history of OHE were enrolled in to the study and were subjected to PHES and ICT. MHE was diagnosed when the PHES was # À5. ICT was considered abnormal when the numbers of ICT lures were more than 14. Results: Forty-one (40.2%) patients had MHE. There were 40 patients with normal PHES and ICT, 32 with abnormal PHES and ICT, 9 with abnormal PHES and normal ICT, and 21 with abnormal ICT and normal PHES score. ICT had 78% sensitivity and 65.6% specificity and an areaunder-the-curve value of 0.735 (95% CI = 0.632-0.830) for the diagnosis of MHE. In patients with cirrhosis, ICT did not correlate with severity of liver disease as measured by CTP score (r = 0.044, P = 0.658) and MELD score (r = 0.176, P = 0.077). ICT did not predict survival as well as PHES; while 6 (11.3%) patients died among those who had altered ICT compared to 4 (8.2%) patients who did not have altered ICT (P = 0.74), 8 (19.5%) patients died among those who had altered PHES compared to 2 (3.3%) patients who did not have altered PHES (P = 0.013). Conclusion: ICT is not as useful as PHES in diagnosing MHE in patients with cirrhosis of the liver. It does not correlate with disease severity and predict survival as well as PHES. ( J CLIN EXP HEPATOL 2012;2:306-314)

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Section: Prevalence Of Minimal Hepatic Encephalopathymentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%