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Abstract

Psychometric performance has been reported to be related to brain atrophy in cirrhotics, but the relationship between brain atrophy and EEG findings is still unknown. The aim of this study was to ascertain the relationship among brain atrophy, EEG, and cognitive performance in cirrhotics. Sixty-eight cirrhotics (age = 55 +/- 10 years; males-66%) underwent psychometric evaluation (Symbol Digit Test, Trail Making Test-Part A, Scan test), EEG recording and spectral analysis (S-EEG), and brain CT scan. Central brain atrophy was ascertained by the following indexes of brain atrophy: the Evans' index, the bicaudate index, the cella media index, the bifrontal index, and the ventricular index; cortical brain atrophy by the sulci index. The severity of liver failure was assessed by the Child-Pugh score: 18% of patients were Child-Pugh Class A, 50% Class B, and 32% Class C. Central and cortical atrophies were found to be correlated with age, but not with the Child-Pugh score. Psychometric performance and the EEG mean dominant frequency (MDF) were found to be correlated with brain atrophy. Multivariate analysis showed that a poor psychometric performance was independently predicted by EEG slowing (MDF: p < 0.01) and by central brain atrophy (cella media index: p < 0.01). In conclusion, brain atrophy was associated with a poor psychometric performance and EEG alterations in cirrhosis. Both brain atrophy and EEG alterations independently predicted cognitive dysfunction in cirrhotic patients.

Altered Topological Properties of Gray Matter Structural Covariance Networks in Minimal Hepatic Encephalopathy

“…Patients with MHE showed more serious brain atrophy as compared with those without MHE (Guevara et al, 2011 ). A previous study has suggested that structural alterations are associated with lower psychometric performance of cirrhotic patients (Amodio et al, 2003 ).…”

Abnormalities in the Polysomnographic, Adenosine and Metabolic Response to Sleep Deprivation in an Animal Model of Hyperammonemia

“…Previously published literature mostly documents abnormalities in the levels of the branched chain amino acids (Soeters and Fischer, 1976 ; Tajiri and Shimizu, 2013 ), while we observed a reduction of virtually all amino acids measured. This may relate to the notion that chronic hyperammonemia results in brain atrophy, which may be mediated by disturbed protein synthesis/regeneration due to insufficient amino acid availability (Amodio et al, 2003 ; Garcia-Martinez et al, 2011 ). Our findings may have been confounded, to some extent, by the fact that animals fed the ammonia-enriched diet most likely ate less, and tended to grow less.…”

Useful Tests for Hepatic Encephalopathy in Clinical Practice

“…Limitations to this study included that while the Scan test software provides an overall Z score, which is corrected for age/educational attainment, the presented weighed RTs were not normalised, and should be considered valid for populations of patients with cirrhosis similar to that used in this study 45 . Amodio and colleagues found that, among various types of psychometric tests such as the Trail-making Tests and Symbol Digit Modality Tests, the scan test was the most closely related to central brain atrophy 47 . About 50% of cirrhotic patients performed poorly on the scan test, making it valuable in detecting the neuropsychological impairment caused by cirrhosis.…”