Validation of a Paper and Pencil Test Battery for the Diagnosis of Minimal Hepatic Encephalopathy in Korea

Jeong, Jae Yoon; Jun, Dae Won; Daiseg, Bai; Kim, Ji Yean; Sohn, Joo Hyun; Ahn, Sang Bong; Kim, Sang Gyune; Kim, Tae Yeob; Kim, Hyoung Su; Jeong, Soung Won; Cho, Yong Kyun; Song, Do Seon; Kim, Hee Yeon; Jung, Young Kul; Yoon, Eileen L.

doi:10.3346/jkms.2017.32.9.1484

Cited by 11 publications

(17 citation statements)

References 21 publications

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“…16 (22.85%) CPC-C patients had NCT-A exceeding 450 sec which was not seen in the control population. Better psychometric test performance was seen with lower CPC grading in other studies as well [10]. CPC score was found to have a positive predictive value in patients developing MHE and this finding was similar to other studies [3].…”

Section: Discussionsupporting

confidence: 88%

“…13 patients had cirrhosis of unknown etiology. This finding was different from that of Maric et al [10] where 43% had chronic hepatitis B infection and 50% had chronic hepatitis C viral infection as well as from the study of Sharma et al 8 where chronic Hepatitis B infection was the commonest type. Wang et al in their study found chronic hepatitis B infection and concomitant alcoholic liver disease as the second most common cause of MHE [11].…”

Section: Discussioncontrasting

confidence: 85%

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A Study of EEG Alpha Wave Patterns in Patients with Cirrhosis and Minimal Hepatic Encephalopathy

Swami¹,

Nath²,

Thakuria³

et al. 2018

JGPLD

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Background: Minimal Hepatic Encephalopathy (MHE) is now increasingly described in patients with cirrhosis without any overt abnormalities on clinical examination. The diagnosis of MHE is based on multiple tests including a combination of paper and pencil tests, computerised tests and neurophysiological tests. Aim of the study: To study the alpha wave patterns in patients with MHE as this has been sparsely reported in the literature. Methods: The study included 70 diagnosed cases of cirrhosis and an equal number of age and sex matched control who were subjected to two paper and pencil tests-NCT-A and DST along with EEG. Results and observations: Of the 70 patients included in the study, 56 (80%) was in CPC-A class. MHE was present in 52 (74.28%) cases of which 38 belonged to CPC-A class. In patients with MHE, alpha wave frequency (10.82 ±0.41Hz) was significantly lower than those in controls (11.52 ± 0.64 Hz) (p< 0.05). Alpha wave amplitude was lower in MHE patients (35 ± 2.78 µV) than in controls (48.18 ± 3.59 µV) (p < 0.05). The frequency and amplitude decreased with higher grades of CPC and higher NCT-A. No difference was noted in the pattern of other wave forms in EEG between patients with MHE and controls. Conclusion: A lower frequency and amplitude of alpha wave along with abnormal NCT-A can be predictive of MHE in cirrhosis.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 85%

A Study of EEG Alpha Wave Patterns in Patients with Cirrhosis and Minimal Hepatic Encephalopathy

Swami¹,

Nath²,

Thakuria³

et al. 2018

JGPLD

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“…208 The Korean paper and pencil test (KPPT) to evaluate MHE in Korean patients with liver cirrhosis was developed with the support of the Korean Association for the Study of the Liver. 325,326 The KPPT consists of six tests: NCT-A, NCT-B, digit span test (DST), symbol digit modality test (SDMT), word list memory test, and Medical College of Georgia Complex figures. The KPPT short version is configured to be relatively simple to use and contains the NCT-A, NCT-B, DST, and SDMT.…”

Section: Paper and Pencil Testingmentioning

confidence: 99%

“…A recent prospective multicenter study validated the KPPT short version in Korean patients with liver cirrhosis. 325 The KPPT is available at http://encephalopathy. or.kr/inspection.…”

Section: Paper and Pencil Testingmentioning

confidence: 99%

KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications

2020

Clin Mol Hepatol

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clinical practice. Therefore, these revised guidelines for the treatment of varices and HE are offered for Korean practice to reflect the latest research results and extensive discussions within the revision committee. This guideline contains the opinions of experts and is intended to be a practical reference for the care of patients with varices and HE; it is not an absolute standard of care. The best choices for each patient's care vary from case to case, and the judgment of the doctor in charge is important. As medical evidence and new findings accumulate in the future, these guidelines will require ongoing supplementation and revision. This guideline may not be modified or altered without permission. Target population This guideline discusses patients with varices, HE, and related complications (esophageal varices [EVs] and bleeding, gastric varices and bleeding, portal hypertensive gastropathy, covert and overt HE) caused by liver cirrhosis. It is intended for clinicians and other medical personnel who are in charge of diagnosing and treating patients with liver cirrhosis. This guideline is also intended to provide practical clinical and educational information and directions for resident physicians and fellows in training, practitioners, and their trainers and supervisors. Development, funding, and revision process Comprising 14 hepatologists, the Clinical Practice Guideline Committee for Liver Cirrhosis: Varices, HE, and related complications (the Committee) was organized by the KASL Board of Executives. Funding for the revisions was provided by KASL. Each committee member collected and analyzed source data in his or her own field, and the members then wrote the manuscript together. Literature review The Committee selected keywords and questions using PICO (Patient/Problem, Intervention, Comparison, Outcome) assessments and systematically collected and reviewed international and domestic literature available in PubMed, MEDLINE, Kore-aMed, the Korean Medical Database, and other databases. In addition to published articles, abstracts of important meetings published before January 2019 were evaluated.

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“…The notion of minimal hepatic encephalopathy (MHE) was developed for the rst time in the 1970s when cirrhotic patients with normal physical examination had pathological neuropsychological tests [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

Normalization of the Psychometric Encephalopathy Score in Cameroonian Population

Djomatcho

Kowo

Ndam

et al. 2020

Preprint

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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. Aim: 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 December 1st, 2018 to July 31st, 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the Number Connection Test-A (NCT-A), Number Connection Test-B (NCT-B), Serial Dotting Test (SDT), Line Tracing Test (LTT) were expressed in seconds and those of the Digit Symbol Test (DST) 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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Validation of a Paper and Pencil Test Battery for the Diagnosis of Minimal Hepatic Encephalopathy in Korea

Cited by 11 publications

References 21 publications

A Study of EEG Alpha Wave Patterns in Patients with Cirrhosis and Minimal Hepatic Encephalopathy

A Study of EEG Alpha Wave Patterns in Patients with Cirrhosis and Minimal Hepatic Encephalopathy

KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications

Normalization of the Psychometric Encephalopathy Score in Cameroonian Population

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