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 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 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 Activation of soluble guanylate cyclase by nitric oxide in lymphocytes correlates with minimal hepatic encephalopathy in cirrhotic patients

2007 ◽  
Vol 7 (Suppl 1) ◽  
pp. P18
Author(s):  
Vicente Felipo ◽  
Blanca Piedrafita ◽  
Amparo Urios ◽  
Miguel A Serra ◽  
A del Olmo ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Hepatic Encephalopathy ◽  
Guanylate Cyclase ◽  
Soluble Guanylate Cyclase ◽  
Minimal Hepatic Encephalopathy ◽  
Cirrhotic Patients

scholarly journals Prevalence of minimal hepatic encephalopathy in cirrhotic patients

2011 ◽  
Vol 10 ◽  
pp. S40-S44 ◽  
Author(s):  
Héctor Jesús Maldonado-Garza ◽  
Genaro Vázquez-Elizondo ◽  
Juan Obed Gaytán-Torres ◽  
Ángel Ricardo Flores-Rendón ◽  
Martha Graciela Cárdenas-Sandoval ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Minimal Hepatic Encephalopathy ◽  
Cirrhotic Patients

IL-6 and IL-18 in Blood May Discriminate Cirrhotic Patients With and Without Minimal Hepatic Encephalopathy

2009 ◽  
Vol 43 (3) ◽  
pp. 272-279 ◽  
Author(s):  
Carmina Montoliu ◽  
Blanca Piedrafita ◽  
Miguel A. Serra ◽  
Juan A. del Olmo ◽  
Amparo Urios ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Minimal Hepatic Encephalopathy ◽  
Cirrhotic Patients
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