Faculty Opinions recommendation of Lactulose reduces bacterial DNA translocation, which worsens neurocognitive shape in cirrhotic patients with minimal hepatic encephalopathy.

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.

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Normalisation of the psychometric encephalopathy score within the Cameroonian population

BMC Gastroenterology ◽

10.1186/s12876-021-01858-7 ◽

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.

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Performance characterization of a novel electronic number connection test to detect minimal hepatic encephalopathy in cirrhotic patients

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0000000000000806 ◽

2017 ◽

Vol 29 (4) ◽

pp. 456-463 ◽

Cited By ~ 7

Author(s):

Tilo Wuensch ◽

Darius Ferenc Ruether ◽

Caroline Zöllner ◽

Tobias Mueller ◽

Tobias Jung ◽

...

Keyword(s):

Hepatic Encephalopathy ◽

Minimal Hepatic Encephalopathy ◽

Performance Characterization ◽

Cirrhotic Patients ◽

Number Connection Test

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

BMC Pharmacology ◽

10.1186/1471-2210-7-s1-p18 ◽

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

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Predictive models of minimal hepatic encephalopathy for cirrhotic patients based on large-scale brain intrinsic connectivity networks

Scientific Reports ◽

10.1038/s41598-017-11196-y ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 2

Author(s):

Yun Jiao ◽

Xun-Heng Wang ◽

Rong Chen ◽

Tian-Yu Tang ◽

Xi-Qi Zhu ◽

...

Keyword(s):

Hepatic Encephalopathy ◽

Predictive Models ◽

Large Scale ◽

Minimal Hepatic Encephalopathy ◽

Intrinsic Connectivity ◽

Cirrhotic Patients ◽

Intrinsic Connectivity Networks

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Reduced Cortical Complexity in Cirrhotic Patients with Minimal Hepatic Encephalopathy

Neural Plasticity ◽

10.1155/2020/7364649 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 2

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.

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