Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C

Abstract

Objective:This study examined neurologic abnormalities (as measured by proton magnetic resonance spectroscopy imaging and diffusion tensor imaging), neurocognitive performance, and fatigue among a sample of adults with hepatitis C virus (HCV). We hypothesized that HCV+ individuals would demonstrate structural brain abnormalities and neurocognitive compromise consistent with frontostriatal dysfunction as well as increased fatigue compared to controls.Method:Participants were 76 individuals diagnosed with HCV and 20 controls who underwent a comprehensive neurocognitive evaluation and clinical assessments. A subset of the HCV+ participants (n = 29) and all controls underwent MRI.Results:Individuals diagnosed with chronic HCV infection demonstrated greater fractional anisotropy in the striatum as well as greater mean diffusivity in the fronto-occiptal fasciculus and external capsule compared to HCV− controls. HCV+ participants also demonstrated lower levels of N-acetylaspartate in bilateral parietal white matter and elevations in myo-inosital (mI) in bilateral frontal white matter compared to HCV− controls (all p values < 0.05). HCV+ participants also demonstrated significantly poorer neuropsychological performance, particularly in processing speed and verbal fluency. HCV+ patients reported higher levels of fatigue than controls, and fatigue was significantly correlated with diffusivity in the superior fronto-occipital fasciculus, elevations in mI in frontal white matter, and overall cognitive performance.Conclusions:Our results suggest that HCV-associated neurologic complications disrupt frontostriatal structures, which may result in increased fatigue and poorer cognitive performance, particularly in those cognitive domains regulated by frontostriatal regions.

Precuneus abnormalities in middle-aged to older adults with depressive symptoms: An analysis of BDI-II symptom dimensions

“…Previous work has shown stronger associations of somatic symptoms, compared to other symptom dimensions, with cognitive functioning (Brailean et al, 2016; Korten et al, 2014) and both gray and white matter changes in the brain (Dotson et al, 2013; Kirton et al, 2014; Tang et al, 2014; Thames et al, 2015). Moreover, higher levels of somatic symptoms have been shown to predict more neuroinflammation in women with MDD (Dannehl et al, 2014), suggesting that somatic symptoms, rather than depressive symptoms as a whole, may be related to factors that are known to mediate the cognitive and brain changes seen in MDD.…”

Extrahepatic comorbidities associated with hepatitis C virus in HIV-infected patients

“…These alterations were correlated with microstructural abnormalities in frontostriatal structures [76].…”

Alcohol intake alters immune responses and promotes CNS viral persistence in mice

“…Fatigue, mood disturbances, and cognitive dysfunction are frequent in patients with chronic HCV infection, including those who have mild liver disease [3–6]. These findings raise the possibility that HCV infection of the brain could be directly related to psychiatric and cognitive impairments, as has been demonstrated with other chronic viral infections [ e.g ., human immunodeficiency virus (HIV) [7]].…”