scholarly journals Reduced Cortical Complexity in Cirrhotic Patients with Minimal Hepatic Encephalopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Qiu-Feng Chen ◽  
Xiao-Hong Zhang ◽  
Tian-Xiu Zou ◽  
Nao-Xin Huang ◽  
Hua-Jun Chen
Keyword(s):  
Hepatic Encephalopathy ◽  
Cognitive Performance ◽  
Gray Matter Volume ◽  
Structural Complexity ◽  
Cingulate Cortex ◽  
Minimal Hepatic Encephalopathy ◽  
Anterior Cingulate ◽  
Psychiatric Disease ◽  
Cirrhotic Patients ◽  
The Right

Purpose. Gray matter volume loss, regional cortical thinning, and local gyrification index alteration have been documented in minimal hepatic encephalopathy (MHE). Fractal dimension (FD), another morphological parameter, has been widely used to describe structural complexity alterations in neurological or psychiatric disease. Here, we conducted the first study to investigate FD alterations in MHE. Methods and Materials. We performed high-resolution structural magnetic resonance imaging on cirrhotic patients with MHE (n=20) and healthy controls (n=21). We evaluated their cognitive performance using the psychometric hepatic encephalopathy score (PHES). The regional FD value was calculated by Computational Anatomy Toolbox (CAT12) and compared between groups. We further estimated the association between patients’ cognitive performance and FD values. Results. MHE patients presented significantly decreased FD values in the left precuneus, left supramarginal gyrus, right caudal anterior cingulate cortex, right isthmus cingulate cortex, right insula, bilateral pericalcarine cortex, and bilateral paracentral cortex compared to normal controls. In addition, the FD values in the right isthmus cingulate cortex and right insula were shown to be positively correlated with patients’ cognitive performance. Conclusion. Aberrant cortical complexity is an additional characteristic of MHE, and FD analysis may provide novel insight into the neurobiological basis of cognitive dysfunction in MHE.

scholarly journals Motor and Cognitive Performance in Patients with Liver Cirrhosis with Minimal Hepatic Encephalopathy

2020 ◽  
Vol 9 (7) ◽  
pp. 2154
Author(s):  
Constanza San Martín-Valenzuela ◽  
Aroa Borras-Barrachina ◽  
Juan-José Gallego ◽  
Amparo Urios ◽  
Víctor Mestre-Salvador ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Cognitive Performance ◽  
Verbal Fluency ◽  
Rating Scale ◽  
Minimal Hepatic Encephalopathy ◽  
Hand Strength ◽  
Gait Velocity ◽  
Motor Speed ◽  
Adult Intelligence Scale ◽  
Cirrhotic Patients

Minimal hepatic encephalopathy (MHE) is associated with mild cognitive impairment and frailty. This study aims to identify cognitive and motor differences in cirrhotic patients with and without MHE, and the correlations between motor signs and cognitive performance. Gait, balance, hand strength and motor speed performance were evaluated in 66 cirrhotic patients (38 without and 28 with MHE, according to the Psychometric Hepatic Encephalopathy Score (PHES). Cognitive performance was measured with the Mini-Mental State Examination, Verbal Fluency Test, Aprendizaje Verbal España-Complutense Test (TAVEC), Wechsler Adult Intelligence Scale III, Hamilton Depression and Anxiety Rating Scale and Functioning Assessment Short Test (FAST). MHE patients performed worse than patients without MHE in cognitive and autonomous functioning, learning and long-term memory, and verbal fluency. The same pattern was found in gait, center of pressure movement, variability of hand strength performance and hand motor speed. In MHE patients, high correlations were found between balance and FAST test, gait velocity and verbal skills, hand strength variability and anxiety and depression, and motor speed and FAST and TAVEC. MHE patients showed worse motor and cognitive performance than patients without MHE. MHE patients could have impaired movement control expressed as bradykinesia, and this reduced motor performance could correlate with cognitive performance.

scholarly journals Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function

2021 ◽  
Vol 10 (2) ◽  
pp. 239
Author(s):  
Dalia Rega ◽  
Mika Aiko ◽  
Nicolás Peñaranda ◽  
Amparo Urios ◽  
Juan-José Gallego ◽  
...  
Keyword(s):  
Nervous System ◽  
Hepatic Encephalopathy ◽  
Quantitative Sensory Testing ◽  
Autonomic Function ◽  
Thermal Sensitivity ◽  
Somatosensory System ◽  
Minimal Hepatic Encephalopathy ◽  
Heat Pain ◽  
Sensory Testing ◽  
Cirrhotic Patients

Cirrhotic patients may experience alterations in the peripheral nervous system and in somatosensory perception. Impairment of the somatosensory system could contribute to cognitive and motor alterations characteristic of minimal hepatic encephalopathy (MHE), which affects up to 40% of cirrhotic patients. We assessed the relationship between MHE and alterations in thermal, vibration, and/or heat pain sensitivity in 58 cirrhotic patients (38 without and 20 with MHE according to Psychometric Hepatic Encephalopathy Score) and 39 controls. All participants underwent attention and coordination tests, a nerve conduction study, autonomic function testing, and evaluation of sensory thresholds (vibration, cooling, and heat pain detection) by electromyography and quantitative sensory testing. The detection thresholds for cold and heat pain on the foot were higher in patients with, than those without MHE. This hyposensitivity was correlated with attention deficits. Reaction times in the foot were longer in patients with, than without MHE. Patients with normal sural nerve amplitude showed altered thermal sensitivity and autonomic function, with stronger alterations in patients with, than in those without MHE. MHE patients show a general decrease in cognitive and sensory abilities. Small fibers of the autonomic nervous system and thermal sensitivity are altered early on in MHE, before large sensory fibers. Quantitative sensory testing could be used as a marker of MHE.

scholarly journals Normalisation of the psychometric encephalopathy score within the Cameroonian population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Larissa Pessidjo Djomatcho ◽  
Mathurin Pierre Kowo ◽  
Antonin Ndjitoyap Ndam ◽  
Sylvain Raoul Simeni Njonnou ◽  
Gabin Ulrich Kenfack ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Healthy Volunteers ◽  
Clinical Signs ◽  
Minimal Hepatic Encephalopathy ◽  
Education Level ◽  
Multicentric Study ◽  
Tracing Test ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Number Connection Test

Abstract Background Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. Psychometric Hepatic Encephalopathy Score (PHES) is a gold standard test for the early diagnosis of MHE in cirrhotic patients. The aim of this study was to standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients. Methods This was a prospective, multicentric study from 1 December 2018 to 31 July 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the number connection test-A, number connection test-B, serial dotting test, line tracing test were expressed in seconds and those of the digit symbol test in points. Results A total of 102 healthy volunteers (54 men, 48 women) and 50 cirrhotic patients (29 men, 31 women) were included. The mean age was 38.1 ± 12.55 years in healthy volunteers and 49.3 ± 15.6 years in cirrhotic patients. The mean years of education level was 11.63 ± 4.20 years in healthy volunteers and 9.62 ± 3.9 years in cirrhotic patients. The PHES of the healthy volunteer group was − 0.08 ± 1.28 and the cut-off between normal and pathological values was set at − 3 points. PHES of the cirrhotic patients was − 7.66 ± 5.62 points and significantly lower than that of volunteers (p < 0.001). Prevalence of MHE was 74% among cirrhotic patients. Age and education level were associated with MHE. Conclusion PHES cut-off value in Cameroonians is − 3, with MHE prevalence of 74% among cirrhotic patients.

scholarly journals Cerebral Activity Changes in Different Traditional Chinese Medicine Patterns of Psychogenic Erectile Dysfunction Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Qi Liu ◽  
Peihai Zhang ◽  
Junjie Pan ◽  
Zhengjie Li ◽  
Jixin Liu ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Brain Activity ◽  
Cingulate Cortex ◽  
Posterior Cingulate Cortex ◽  
Anterior Cingulate ◽  
Parahippocampal Gyrus ◽  
Cerebral Activity ◽  
The Right

Background.Pattern differentiation is the foundation of traditional Chinese medicine (TCM) treatment for erectile dysfunction (ED). This study aims to investigate the differences in cerebral activity in ED patients with different TCM patterns.Methods.27 psychogenic ED patients and 27 healthy subjects (HS) were enrolled in this study. Each participant underwent an fMRI scan in resting state. The fractional amplitude of low-frequency fluctuation (fALFF) was used to detect the brain activity changes in ED patients with different patterns.Results.Compared to HS, ED patients showed an increased cerebral activity in bilateral cerebellum, insula, globus pallidus, parahippocampal gyrus, orbitofrontal cortex (OFC), and middle cingulate cortex (MCC). Compared to the patients with liver-qi stagnation and spleen deficiency pattern (LSSDP), the patients with kidney-yang deficiency pattern (KDP) showed an increased activity in bilateral brainstem, cerebellum, hippocampus, and the right insula, thalamus, MCC, and a decreased activity in bilateral putamen, medial frontal gyrus, temporal pole, and the right caudate nucleus, OFC, anterior cingulate cortex, and posterior cingulate cortex (P<0.005).Conclusions.The ED patients with different TCM patterns showed different brain activities. The differences in cerebral activity between LSSDP and KDP were mainly in the emotion-related regions, including prefrontal cortex and cingulated cortex.

scholarly journals Stress-induced anatomical changes in white and gray matter: a review of literature

2020 ◽  
Vol 76 (06) ◽  
pp. 6400-2020
Author(s):  
IWONA ŁUSZCZEWSKA-SIERAKOWSKA ◽  
KAMIL JONAK
Keyword(s):  
White Matter ◽  
Gray Matter ◽  
Traumatic Event ◽  
Gray Matter Volume ◽  
Hippocampal Neurogenesis ◽  
Anterior Cingulate ◽  
Total Brain Volume ◽  
Extreme Stress ◽  
Mri Morphometry ◽  
The Right

Post traumatic stress disorder (PTSD) is a psychiatric abnormality caused by a drastic traumatic event or extreme stress, that exceeds the capability to adapt. There are many papers reporting anatomical brain changes induced by trauma and extreme stress, not only in white matter but in gray matter as well. Extreme stress and trauma are connected with elevation of cortisol level, which may cause damage to the hippocampus and may interfere with the anatomy of the hippocampus as well as its microstructure and cell number. Stress may inhibit the hippocampal neuroregeneration as well as hippocampal neurogenesis and even induce neuronal death within the hippocampus. Diffusor tensor imaging (DTI) is a powerful method enabling the visualization of the microstructure integrity of white matter, to evaluate the changes (rate and directionality) of water diffusion within myelin tracts and provide enhanced images of white matter tracts compared to traditional MRI morphometry images. One can evaluate the differences in white matter using fractional anisotropy (FA), which is a scalar metric of the degree of anisotropy and diffusion direction of water molecules, indicating fiber density, mylination and axon diameter. Many studies report reduced gray matter volume caused by extreme stress or trauma in people both with the diagnosis of PTSD as well as stress-exposed non PTSD in comparison to healthy controls. Studies have revealed reduced volume mostly in the hippocampus but also in regions such as anterior cingulate, corpus callosum, insula, septum pellucidum, subcallosal cortex, amygdala, prefrontal cortex and total brain volume. The right hippocampus may be prone to the effect of stress much more than the left hippocampus. Moreover, comparing trauma-exposed non-PTSD and PTSD participants, they have found volumetric abnormalities only within the right hippocampus among the PTSD group. They suggest an additional pathological process underlying PTSD, connected with the right hippocampus volume.

scholarly journals Attentional bias to threat and gray mater volume morphology in high anxious individuals

2020 ◽  
Author(s):  
Joshua M. Carlson ◽  
Lin Fang
Keyword(s):  
Attentional Bias ◽  
Parietal Cortex ◽  
Gray Matter ◽  
Posterior Parietal Cortex ◽  
Gray Matter Volume ◽  
Anterior Cingulate ◽  
Brain Morphology ◽  
Matter Volume ◽  
Posterior Parietal ◽  
The Right

AbstractIn a sample of highly anxious individuals, the relationship between gray matter volume brain morphology and attentional bias to threat was assessed. Participants performed a dot-probe task of attentional bias to threat and gray matter volume was acquired from whole brain structural T1-weighted MRI scans. The results replicate previous findings in unselected samples that elevated attentional bias to threat is linked to greater gray matter volume in the anterior cingulate cortex, middle frontal gyrus, and striatum. In addition, we provide novel evidence that elevated attentional bias to threat is associated with greater gray matter volume in the right posterior parietal cortex, cerebellum, and other distributed regions. Lastly, exploratory analyses provide initial evidence that distinct sub-regions of the right posterior parietal cortex may contribute to attentional bias in a sex-specific manner. Our results illuminate how differences in gray matter volume morphology relate to attentional bias to threat in anxious individuals. This knowledge could inform neurocognitive models of anxiety-related attentional bias to threat and targets of neuroplasticity in anxiety interventions such as attention bias modification.

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