Spatio-temporal decomposition of the electroencephalogram in patients with cirrhosis

Montagnese, Sara; Jackson, Clive; Morgan, Marsha Y.

doi:10.1016/j.jhep.2006.10.015

Cited by 69 publications

(45 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Of note, this is a typical neurophysiological feature of reduced vigilance in healthy individuals. 4 In agreement with this finding, previous data-based on less accurate EEG mapping technique-suggested an increase the central-frontal alpha.…”

Section: The Eegmentioning

confidence: 98%

Clinical Neurophysiology of Hepatic Encephalopathy

Amodio

Montagnese

2015

Journal of Clinical and Experimental Hepatology

Self Cite

View full text Add to dashboard Cite

Background/Objectives: Hepatic encephalopathy (HE) has relevant impact on the quality of life of patients and their caregivers and causes relevant costs because of hospitalizations and work days lost. Its quantification is important to perform adequate clinical trials on this relevant complication of cirrhosis and portal-systemic shunting. Clinical neurophysiology, which detects functional alterations of the nervous system, has been applied to the study of HE for over 60 years. This review aims at summarizing and clarifying the role of neurophysiologic techniques in the study of HE. Methods: A narrative review was performed aiming at interpreting the cited papers and the techniques on the basis of their physiological and pathophysiological meaning. Results: The potential role of EEG, quantified EEG, evoked potentials-both exogenous, endogenous and motor-have been clarified to the reader that may be unfamiliar with neurophysiology. Conclusions: The EEG, reflecting the oscillatory changes of neural network is the preferable tool to detect and monitor HE, with the exception of its most severe stage, when EEG flattens. SSEP and MEP have indication to detect and monitor transmission alterations that are likely related to myelin changes and microedema. ( J CLIN EXP HEPATOL 2014;5:S60-S68)

show abstract

Section: The Eegmentioning

confidence: 98%

Clinical Neurophysiology of Hepatic Encephalopathy

Amodio

Montagnese

2015

Journal of Clinical and Experimental Hepatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…to the International 10 -20 system (Walter-Graphtec system equipment). The traces underwent spectral analysis and were classified according to Amodio et al (2), with a modified slow theta activity threshold of 30% (38). Neuropsychiatric status was classified as 1) unimpaired: no clinical evidence of hepatic encephalopathy and no defining EEG or psychometric abnormalities; 2) minimal hepatic encephalopathy: no clinical evidence of hepatic encephalopathy but abnormal EEG and/or impaired psychometric performance; and 3) overt hepatic encephalopathy: clinically evident neuropsychiatric disturbances.…”

Section: Neuropsychiatric Assessmentmentioning

confidence: 99%

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Mani¹,

Montagnese²,

Jackson³

et al. 2009

American Journal of Physiology-Gastrointestinal and Liver Physi

Self Cite

111

View full text Add to dashboard Cite

Mani AR, Montagnese S, Jackson CD, Jenkins CW, Head IM, Stephens RC, Moore KP, Morgan MY. Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy. Am J Physiol Gastrointest Liver Physiol 296: G330 -G338, 2009. First published November 20, 2008 doi:10.1152/ajpgi.90488.2008.-Heart rate variability (HRV) is reduced in several clinical settings associated with either systemic inflammation or neuropsychiatric impairment. The possibility that the changes in HRV observed in patients with neuropsychiatric impairment might relate to the overproduction of inflammatory cytokines does not seem to have been considered in the studies undertaken to date. HRV is decreased in patients with liver cirrhosis but its relationship to the impairment of neuropsychiatric performance, commonly observed in these patients, is unknown. The aim of this study was to investigate the relationship between HRV, hepatic encephalopathy, and production of inflammatory cytokines in patients with cirrhosis. Eighty patients with cirrhosis [53 men, 27 women; mean (Ϯ1SD) age 54 Ϯ 10 yr], classified as neuropsychiatrically unimpaired or as having minimal or overt hepatic encephalopathy, and 11 healthy subjects were studied. HRV was assessed by applying Poincaré plot analysis to the R-R interval series on a 5-min ECG. Inflammatory cytokines (TNF-␣, IL-6, IL-10, and IL-12) were measured in a subgroup of patients. Long-term R-R variability was significantly decreased in the patients with cirrhosis, in parallel with the degree of neuropsychiatric impairment (P Ͻ 0.01) and independently of the degree of hepatic dysfunction (P ϭ 0.011). The relative risk of death increased by 7.7% for every 1-ms drop in this variable. Plasma levels of IL-6 significantly correlated with indexes of both HRV and neuropsychiatric performance. The changes observed in HRV and in neuropsychiatric status in patients with cirrhosis are significantly correlated, most likely reflecting a common pathogenic mechanism mediated by inflammatory cytokines.

show abstract

“…Neurophysiologic studies have demonstrated that HE causes reduction of the oscillatory properties of neural networks [110,111] with movement of EEG alpha frequencies from the posterior cortical areas to the anterior ones (frontal cortex) in mild HE [112], and occurrence of triphasic waves in severe HE [67].…”

Section: Organ Levelmentioning

confidence: 99%

Hepatic encephalopathy

Amodio¹

2015

Cirrhosis: A Practical Guide to Management

View full text Add to dashboard Cite

Spatio-temporal decomposition of the electroencephalogram in patients with cirrhosis

Cited by 69 publications

References 37 publications

Clinical Neurophysiology of Hepatic Encephalopathy

Clinical Neurophysiology of Hepatic Encephalopathy

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Hepatic encephalopathy

Contact Info

Product

Resources

About