Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis

Gazda, Jakub; Drotár, Peter; Dražilová, Sylvia; Gazda, Juraj; Gazda, Matej; Janíčko, Martin; Jarčuška, Peter

doi:10.3390/jpm11111090

Cited by 6 publications

(2 citation statements)

References 73 publications

(96 reference statements)

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“…MHE can be detected by special, time-consuming psychometric tests. Recently, as the diagnostic approach of MHE through artificial intelligence and machine learning is progressing, uncertainty resolution is being studied [ 128 ].…”

Section: Future Directionsmentioning

confidence: 99%

The Link between Gut Microbiota and Hepatic Encephalopathy

Won

Gupta

et al. 2022

IJMS

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Hepatic encephalopathy (HE) is a serious complication of cirrhosis that causes neuropsychiatric problems, such as cognitive dysfunction and movement disorders. The link between the microbiota and the host plays a key role in the pathogenesis of HE. The link between the gut microbiome and disease can be positively utilized not only in the diagnosis area of HE but also in the treatment area. Probiotics and prebiotics aim to resolve gut dysbiosis and increase beneficial microbial taxa, while fecal microbiota transplantation aims to address gut dysbiosis through transplantation (FMT) of the gut microbiome from healthy donors. Antibiotics, such as rifaximin, aim to improve cognitive function and hyperammonemia by targeting harmful taxa. Current treatment regimens for HE have achieved some success in treatment by targeting the gut microbiota, however, are still accompanied by limitations and problems. A focused approach should be placed on the establishment of personalized trial designs and therapies for the improvement of future care. This narrative review identifies factors negatively influencing the gut–hepatic–brain axis leading to HE in cirrhosis and explores their relationship with the gut microbiome. We also focused on the evaluation of reported clinical studies on the management and improvement of HE patients with a particular focus on microbiome-targeted therapy.

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Section: Future Directionsmentioning

confidence: 99%

The Link between Gut Microbiota and Hepatic Encephalopathy

Won

Gupta

et al. 2022

IJMS

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“…In particular, using information regarding microstructural integrity and water movement through cell membranes of white matter and the total grey matter volume; machine learning can discriminate cirrhotic patients with and without MHE. However, the costs associated with these technologies are high and currently not sustainable in clinical practice [ 20 ].…”

Section: Diagnosis Of Minimal Hepatic Encephalopathymentioning

confidence: 99%

Minimal Hepatic Encephalopathy Affects Daily Life of Cirrhotic Patients: A Viewpoint on Clinical Consequences and Therapeutic Opportunities

Faccioli

Nardelli

Gioia

et al. 2022

JCM

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Minimal hepatic encephalopathy (MHE) is a frequent complication of hepatic encephalopathy (HE) and can affect up to 80% of patients with liver cirrhosis. It is characterized by the lack of obvious clinical signs and the presence of alterations detectable using psychometric or electrophysiological testing focused on attention, working memory, psychomotor speed and visuospatial ability. Ideally, each patient should be tested for this condition because, despite the absence of symptoms, it has severe repercussions on daily life activities. It may be responsible for an inability to drive, sleep disturbances, risk of falls and inability to work. Some studies have highlighted its prognostically unfavorable role on mortality and risk of “overt” HE (OHE). Finally, MHE severely affects the lives of patients and caregivers, altering their quality of life and their socioeconomic status. Several treatments have been proposed for MHE treatment, including non-absorbable disaccharides, poorly absorbable antibiotics, such as rifaximin, probiotics and branched-chain amino acids, with promising results. For this reason, early diagnosis and intervention with appropriate measures is essential, with the aim of improving both performance on psychometric tests, as well as clinical aspects related to this condition.

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Identifying Minimal Hepatic Encephalopathy: A New Perspective from Magnetic Resonance Imaging

Wang,

Yang,

Shang

et al. 2023

Magnetic Resonance Imaging

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Type C hepatic encephalopathy (HE) is a condition characterized by brain dysfunction caused by liver insufficiency and/or portal‐systemic blood shunting, which manifests as a broad spectrum of neurological or psychiatric abnormalities, ranging from minimal HE (MHE), detectable only by neuropsychological or neurophysiological assessment, to coma. Though MHE is the subclinical phase of HE, it is highly prevalent in cirrhotic patients and strongly associated with poor quality of life, high risk of overt HE, and mortality. It is, therefore, critical to identify MHE at the earliest and timely intervene, thereby minimizing the subsequent complications and costs. However, proper and sensitive diagnosis of MHE is hampered by its unnoticeable symptoms and the absence of standard diagnostic criteria. A variety of neuropsychological or neurophysiological tests have been performed to diagnose MHE. However, these tests are nonspecific and susceptible to multiple factors (eg, aging, education), thereby limiting their application in clinical practice. Thus, developing an objective, effective, and noninvasive method is imperative to help detect MHE. Magnetic resonance imaging (MRI), a noninvasive technique which can produce many objective biomarkers by different imaging sequences (eg, Magnetic resonance spectroscopy, DWI, rs‐MRI, and arterial spin labeling), has recently shown the ability to screen MHE from NHE (non‐HE) patients accurately. As advanced MRI techniques continue to emerge, more minor changes in the brain could be captured, providing new means for early diagnosis and quantitative assessment of MHE. In addition, the advancement of artificial intelligence in medical imaging also presents the potential to mine more effective diagnostic biomarkers and further improves the predictive efficiency of MHE. Taken together, advanced MRI techniques may provide a new perspective for us to identify MHE in the future.Level of Evidence3Technical EfficacyStage 2

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Artificial Intelligence and Its Application to Minimal Hepatic Encephalopathy Diagnosis

Cited by 6 publications

References 73 publications

The Link between Gut Microbiota and Hepatic Encephalopathy

The Link between Gut Microbiota and Hepatic Encephalopathy

Minimal Hepatic Encephalopathy Affects Daily Life of Cirrhotic Patients: A Viewpoint on Clinical Consequences and Therapeutic Opportunities

Identifying Minimal Hepatic Encephalopathy: A New Perspective from Magnetic Resonance Imaging

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