Critical flicker frequency: It is time to break down barriers surrounding minimal hepatic encephalopathy

Romero‐Gómez, Manuel

doi:10.1016/j.jhep.2007.04.005

Cited by 21 publications

(4 citation statements)

References 13 publications

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“…Around 40% of cirrhotic patients suffer from minimal hepatic encephalopathy (MHE), with mild cognitive dysfunction which impairs their quality and span of life (Gonzalez-Usano et al, 2014),and some studies have shown that cognitive dysfunction might be induced by liver cirrhosis even in the absence of HE (Romero-Gomez, 2007).According to our findings, 28 days after bile duct ligation, memory of animals significantly decreased in comparison with control and sham groups. We also previously demonstratedmemory impairment induced by cirrhosis in rats, using Y-maze test (Javadi-Paydar et al, 2013).Our result is also in direction with other studies which have shown spatial memory impairment in cholestatic rats (Huang et al, 2009, Huang et al, 2010, Hosseini et al, 2013.…”

Section: Discussionsupporting

confidence: 49%

“…In bile duct ligated animal, hepatocellular excretion of bile constituents is impaired and bile salts accumulation in the body and their deficiency in the intestinal lumen causes cholestasis, which can induce liver cirrhosis at last (Gartung et al, 1996).Hepatic encephalopathy (HE) is one of the most important complications of liver cirrhosis, which presents with cognitive dysfunctions such as learning and memory impairment , but some studies have shown that cognitive dysfunction might be induced by liver cirrhosis even in the absence of HE (Romero-Gomez, 2007).Learning and memory impairment is one of the most challenging complication of cirrhosis and there are no specific treatments for cognitive dysfunction in this disease and all treatments are unsatisfactory (Gonzalez-Usano et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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The effects of intra-dorsal hippocampus infusion of pregnenolone sulfate on memory function and hippocampal BDNF mRNA expression of biliary cirrhosis-induced memory impairment in rats

et al. 2015

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Section: Discussionsupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

The effects of intra-dorsal hippocampus infusion of pregnenolone sulfate on memory function and hippocampal BDNF mRNA expression of biliary cirrhosis-induced memory impairment in rats

et al. 2015

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“…MHE is discernible in prolongation of reaction times in the activities of daily living, such as driving and operating machinery. It has a prognostic value in relation to occurrence of both bouts of acute HE (Saxena et al 2002; Romero-Gómez 2007a; Amodio et al 2001; Amodio et al 1999) and death (Amodio et al 2001; Romero-Gómez et al 2007b). …”

Section: Introductionmentioning

confidence: 99%

Multi-dimensional MR spectroscopy: towards a better understanding of hepatic encephalopathy

et al. 2011

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Hepatic encephalopathy (HE) is normally diagnosed by neuropsychological (NP) tests. The goals of this study were to quantify cerebral metabolites, separate glutamate (Glu) from glutamine (Gln) in patients with minimal hepatic encephalopathy (MHE) as well as healthy subjects using the prior-knowledge fitting (ProFit) algorithm on data acquired by two-dimensional (2D) localized correlated spectroscopic (L-COSY) on two different MR scanners, and to correlate the metabolite changes with neuropsychological (NP) tests. We studied 14 MHE patients and 18 healthy controls using a GE 1.5T Signa MR scanner. Another group of 16 MHE patients and 18 healthy controls were studied using a Siemens 1.5T Avanto MR scanner. The following parameters were used for L-COSY: TR/TE=2s/30ms, 3×3×3cm3 voxel size, 96 Δt1 increments with 8 averages per Δt1. Using the ProFit algorithm, we were able to differentiate Gln from Glu on the GE 1.5T data in the medial frontal white/gray matter. The ratios of myo-inositol (mI), Glu, total choline, scyllo-inositol (sI), phosphoethanolamine (PE), and total N-acetyl aspartate (NAA) showed statistically significant decline in HE patients compared to healthy controls, while the ratio of Gln was significantly increased. Similar trend was seen in the ProFit quantified Siemens 1.5T data in the frontal and occipito-parietal white/gray regions. Among the NP domain scores, motor function, cognitive speed, executive function and the global scores showed significant differences. Excellent correlations between various NP domains and metabolite ratios were also observed. ProFit based cerebral metabolite quantitation enhances the understanding and basis of the current hypothesis of MHE.

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“…Another increasingly used test is the critical flicker frequency test. This has been shown to predict MHE with the advantage of not being affected by age or educational level (23).…”

Section: Burden Of Mhementioning

confidence: 99%

Minimal Hepatic Encephalopathy

Stinton

Jayakumar

2013

Canadian Journal of Gastroenterology

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Minimal hepatic encephalopathy (MHE) is the earliest form of hepatic encephalopathy and can affect up to 80% of cirrhotic patients. By definition, it has no obvious clinical manifestation and is characterized by neurocognitive impairment in attention, vigilance and integrative function. Although often not considered to be clinically relevant and, therefore, not diagnosed or treated, MHE has been shown to affect daily functioning, quality of life, driving and overall mortality. The diagnosis of MHE has traditionally been achieved through neuropsychological examination, psychometric tests or the newer critical flicker frequency test. A new smartphone application (EncephalApp Stroop Test) may serve to function as a screening tool for patients requiring further testing. In addition to physician reporting and driving restrictions, medical treatment for MHE includes non-absorbable disaccharides (eg, lactulose), probiotics or rifaximin. Liver transplantation may not result in reversal of the cognitive deficits associated with MHE.

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Critical flicker frequency: It is time to break down barriers surrounding minimal hepatic encephalopathy

Cited by 21 publications

References 13 publications

The effects of intra-dorsal hippocampus infusion of pregnenolone sulfate on memory function and hippocampal BDNF mRNA expression of biliary cirrhosis-induced memory impairment in rats

The effects of intra-dorsal hippocampus infusion of pregnenolone sulfate on memory function and hippocampal BDNF mRNA expression of biliary cirrhosis-induced memory impairment in rats

Multi-dimensional MR spectroscopy: towards a better understanding of hepatic encephalopathy

Minimal Hepatic Encephalopathy

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