New Methods of Testing and Brain Imaging in Hepatic Encephalopathy

Edula, Raja G Reddy; Pyrsopoulos, Nikolaos

doi:10.1016/j.cld.2015.04.001

Cited by 6 publications

(4 citation statements)

References 68 publications

(69 reference statements)

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“…The gradual deterioration of the connectome gradient observed in this study is consistent with previous findings, which indicate the progressive dysfunction of brain metabolism, 11 brain activity 10 and brain connectivity 22 in HBV‐RC patients with disease advancement. By inspecting the inter‐hemispheric coordination, Ye et al 22 found that NMHE patients had compromised connectivity of the bilateral VIS (cuneus, middle temporal gyrus), and the dysconnectivity further extended to the bilateral dorsal DMN and the bilateral SMN in the MHE stage.…”

Section: Discussionsupporting

confidence: 92%

“…Using a sliding window method, our recent study 9 indicated that a progressive impairment of dynamic functional networks occurs in the development from NMHE to MHE, which also correlated with cognitive deterioration. Although preliminary studies regarding the potential linkage between macroscopic neural phenotypes and cognitive deterioration in HBV‐RC patients as the disease advances have been performed, the underlying molecular basis of these macroscopic neural phenotypes is still unclear 10–12 . Therefore, a comprehensive, translatable understanding of a framework to explore the molecular basis of the macroscopic neural phenotypes shown by MRI is needed.…”

mentioning

confidence: 99%

“…Although preliminary studies regarding the potential linkage between macroscopic neural phenotypes and cognitive deterioration in HBV-RC patients as the disease advances have been performed, the underlying molecular basis of these macroscopic neural phenotypes is still unclear. [10][11][12] Therefore, a comprehensive, translatable understanding of a framework to explore the molecular basis of the macroscopic neural phenotypes shown by MRI is needed.…”

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confidence: 99%

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Association Between MRI‐Assessed Patterns of Connectome Gradient and Gene‐Expression Profiles in Two Independent Patient Cohorts With Hepatitis B Virus‐Related Cirrhosis

Lin

et al. 2023

Magnetic Resonance Imaging

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BackgroundPatients with hepatitis B virus‐related cirrhosis (HBV‐RC) exhibit progressive neurologic dysfunction from primary sensorimotor to high‐order cognition, as their disease advances. However, the exact neurobiologic mechanisms and the potential association with gene‐expression profiles are not fully understood.PurposeTo explore the hierarchical disorganization in the large‐scale functional connectomes in HBV‐RC patients and to investigate its potential underlying molecular basis.Study TypeProspective.PopulationFifty HBV‐RC patients and 40 controls (Cohort 1) and 30 HBV‐RC patients and 38 controls (Cohort 2).Field Strength/SequenceGradient‐echo echo‐planar and fast field echo sequences at 3.0 T (Cohort 1) and 1.5 T (Cohort 2).AssessmentData were processed with Dpabi and the BrainSpace package. Gradient scores were evaluated from global to voxel level. Cognitive measurement and patients grouping were based on psychometric hepatic encephalopathy scores. The whole‐brain microarray‐based gene‐expression data were obtained from the AIBS website.Statistical TestsOne‐way ANOVA, chi‐square test, two‐sample t‐test, Kruskal–Wallis test, Spearman's correlation coefficient (r), the gaussian random field correction, false discovery rate (FDR) correction and the Bonferroni correction. Significance level: P < 0.05.ResultsHBV‐RC patients exhibited a robust and replicable connectome gradient dysfunction, which was significantly associated with the gene‐expression profiles in both cohorts (r = 0.52 and r = 0.56, respectively). The most correlated genes were enriched in γ‐aminobutyric acid (GABA) and GABA‐related receptor genes (FDR q value <0.05). Moreover, the connectome gradient dysfunction at network level observed in HBV‐RC patients correlated with their poor cognitive performance (Cohort 2: visual network, r = −0.56; subcortical network, r = 0.66; frontoparietal network, r = 0.51).Data ConclusionHBV‐RC patients had hierarchical disorganization in the large‐scale functional connectomes, which may underly their cognitive impairment. In addition, we showed the potential molecular mechanism of the connectome gradient dysfunction, which suggested the importance of GABA and GABA‐related receptor genes.Evidence Level2Technical EfficacyStage 2

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

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confidence: 99%

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Association Between MRI‐Assessed Patterns of Connectome Gradient and Gene‐Expression Profiles in Two Independent Patient Cohorts With Hepatitis B Virus‐Related Cirrhosis

Lin

et al. 2023

Magnetic Resonance Imaging

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“…Therefore, it is difficult for patients to sustain repeated puncture since it has relatively severe damage on liver functions. This is the main cause for hepatic encephalopathy (Edula & Pyrsopoulos, ; Ishikawa et al., ).…”

Section: Resultsmentioning

confidence: 99%

Post-operative care of interventional therapy for 40 liver cancer patients with obstructive jaundice

Tong

Chen

et al. 2018

Eur J Cancer Care

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The care of 40 patients with primary liver cancer with obstructive jaundice treated with liver puncture bile drainage or biliary stent implantation was reported. Treated with the interventional therapy, patients were observed closely to identify symptoms of hepatic encephalopathy and pain; diet care was well performed. Bile drainage tube and skin acre were performed carefully. Liver function, bilirubin and other biochemical indicators were monitored; occurrence of bleeding, acute pancreatitis, biliary tract infection, leakage of ascites around drainage tube and other complication were observed with good discharge instruction. After this operation, three rounds of liver had poor function, and hepatic encephalopathy and death occurred during hospitalisation. Seven patients had bloody bile drainage fluid after operation; eight had increased blood amylase; nine had biliary infection and four had leakage of ascites around the drainage tube. After positive treatment and care, the situation was improved with varied degrees of jaundice increase.

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Congenital portosystemic shunts: diagnosis and treatment

et al. 2018

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Congenital portosystemic shunts (CPSS) are rare vascular malformations that create an abnormal connection between portal and systemic veins resulting in complete or partial diversion of the portal flow away from the liver to the systemic venous system. Different anatomic types exist and several classifications have been proposed. They can be associated with other malformations especially cardiac and heterotaxia. The main complications include hepatic encephalopathy, liver tumors, portopulmonary hypertension, and pulmonary arteriovenous shunts. Diagnosis relies on imaging, and prenatal diagnosis is possible. Spontaneous closure of the CPSS is possible in some anatomic forms during the first year of life. When the CPSS remains patent, radiologic or surgical closure of the CPSS may prevent, resolve, or stabilize complications. Interventional radiology plays a key role for both the preoperative evaluation with occlusion test to assess the exact anatomy and to measure portal pressure after occlusion of the CPSS. Endovascular closure is the first option for treatment when possible.

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New Methods of Testing and Brain Imaging in Hepatic Encephalopathy

Cited by 6 publications

References 68 publications

Association Between MRI‐Assessed Patterns of Connectome Gradient and Gene‐Expression Profiles in Two Independent Patient Cohorts With Hepatitis B Virus‐Related Cirrhosis

Association Between MRI‐Assessed Patterns of Connectome Gradient and Gene‐Expression Profiles in Two Independent Patient Cohorts With Hepatitis B Virus‐Related Cirrhosis

Post-operative care of interventional therapy for 40 liver cancer patients with obstructive jaundice

Congenital portosystemic shunts: diagnosis and treatment

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