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Minimal hepatic encephalopathy

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https://www.readbyqxmd.com/read/29023586/reduced-resting-state-connectivity-and-gray-matter-volume-correlate-with-cognitive-impairment-in-minimal-hepatic-encephalopathy
#1
Raquel García-García, Álvaro Javier Cruz-Gómez, Alba Mangas-Losada, Amparo Urios, Cristina Forn, Desamparados Escudero-García, Elena Kosenko, Juan Fermín Ordoño, Joan Tosca, Remedios Giner-Durán, Miguel Angel Serra, César Avila, Vicente Belloch, Vicente Felipo, Carmina Montoliu
BACKGROUND AND AIMS: Minimal hepatic encephalopathy (MHE) is associated with cognitive alterations and changes in connectivity. We assessed the relationship of the abnormalities of resting-state functional connectivity (rs-FC) and gray matter (GM) volume with different cognitive alterations and biochemical parameters associated to MHE. METHODS: Thirty-nine cirrhotic patients (26 without and 13 with MHE) and 24 controls were widely cognitive assessed with a battery of psychometric tests...
2017: PloS One
https://www.readbyqxmd.com/read/29020023/the-continuous-reaction-time-test-for-minimal-hepatic-encephalopathy-validated-by-a-randomized-controlled-multi-modal-intervention-a-pilot-study
#2
M M Lauridsen, S Mikkelsen, T Svensson, J Holm, C Klüver, J Gram, H Vilstrup, O B Schaffalitzky de Muckadell
BACKGROUND: Minimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, a lack of clarity exists as to whether the tests are in fact able to detect changes in cognition. AIM: To examine if the continuous reaction time test (CRT) can detect changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE). METHODS: Firstly, we conducted a reproducibility analysis and secondly measured change in CRT induced by anti-HE treatment in a randomized controlled pilot study: We stratified 44 patients with liver cirrhosis and without clinically manifest HE according to a normal (n = 22) or abnormal (n = 22) CRT...
2017: PloS One
https://www.readbyqxmd.com/read/28965835/dopamine-induces-glutamate-accumulation-in-astrocytes-to-disrupt-neuronal-function-leading-to-pathogenesis-of-minimal-hepatic-encephalopathy
#3
Saidan Ding, Xuebao Wang, Weishan Zhuge, Jianjing Yang, Qichuan Zhuge
Minimal hepatic encephalopathy (MHE) is induced by elevated intracranial dopamine (DA). Glutamate (Glu) toxicity is known to be involved in many neurological disorders. In this study, we investigated whether DA increased Glu levels and collaborated with Glu to impair memory. We found that DA upregulated TAAR1, leading to reduced EAAT2 expression and Glu clearance in primary cortical astrocytes (PCAs). High DA increased TAAR1 expression, and high Glu increased AMPAR expression, inducing the activation of CaN/NFAT signaling and a decrease in the production of BDNF (Brain Derived Nerve Growth Factor)/NT3 (neurotrophin-3) in primary cortical neurons (PCNs)...
September 29, 2017: Neuroscience
https://www.readbyqxmd.com/read/28953991/candesartan-rather-than-losartan-improves-motor-dysfunction-in-thioacetamide-induced-chronic-liver-failure-in-rats
#4
H A Murad, Z J Gazzaz, S S Ali, M S Ibraheem
Minimal hepatic encephalopathy is more common than the acute syndrome. Losartan, the first angiotensin-II receptor blocker (ARB), and candesartan, another widely-used ARB, have protected against developing fibrogenesis, but there is no clear data about their curative antifibrotic effects. The current study was designed to examine their effects in an already-established model of hepatic fibrosis and also their effects on the associated motor dysfunction. Low-grade chronic liver failure (CLF) was induced in 3-month old Sprague-Dawley male rats using thioacetamide (TAA, 50 mg·kg-1·day-1) intraperitoneally for 2 weeks...
September 21, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28932186/da-negatively-regulates-igf-i-actions-implicated-in-cognitive-function-via-interaction-of-psd95-and-nnos-in-minimal-hepatic-encephalopathy
#5
Saidan Ding, Weishan Zhuge, Xuebao Wang, Jianjing Yang, Yuanshao Lin, Chengde Wang, Jiangnan Hu, Qichuan Zhuge
Insulin-like growth factor I (IGF-I) has been positively correlated with cognitive ability. Cognitive decline in minimal hepatic encephalopathy (MHE) was shown to be induced by elevated intracranial dopamine (DA). The beneficial effect of IGF-I signaling in MHE remains unknown. In this study, we found that IGF-I content was reduced in MHE rats and that IGF-I administration mitigated cognitive decline of MHE rats. A protective effect of IGF-I on the DA-induced interaction between postsynaptic density protein 95 (PSD95) and neuronal nitric oxide synthase (nNOS) was found in neurons...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28919805/a-pilot-evaluation-of-a-computer-based-psychometric-test-battery-designed-to-detect-impairment-in-patients-with-cirrhosis
#6
Nicola A Cook, Jin Un Kim, Yasmin Pasha, Mary Me Crossey, Adrian J Schembri, Brian T Harel, Torben Kimhofer, Simon D Taylor-Robinson
BACKGROUND: Psychometric testing is used to identify patients with cirrhosis who have developed hepatic encephalopathy (HE). Most batteries consist of a series of paper-and-pencil tests, which are cumbersome for most clinicians. A modern, easy-to-use, computer-based battery would be a helpful clinical tool, given that in its minimal form, HE has an impact on both patients' quality of life and the ability to drive and operate machinery (with societal consequences). AIM: We compared the Cogstate™ computer battery testing with the Psychometric Hepatic Encephalopathy Score (PHES) tests, with a view to simplify the diagnosis...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28912425/predictive-models-of-minimal-hepatic-encephalopathy-for-cirrhotic-patients-based-on-large-scale-brain-intrinsic-connectivity-networks
#7
Yun Jiao, Xun-Heng Wang, Rong Chen, Tian-Yu Tang, Xi-Qi Zhu, Gao-Jun Teng
We aimed to find the most representative connectivity patterns for minimal hepatic encephalopathy (MHE) using large-scale intrinsic connectivity networks (ICNs) and machine learning methods. Resting-state fMRI was administered to 33 cirrhotic patients with MHE and 43 cirrhotic patients without MHE (NMHE). The connectivity maps of 20 ICNs for each participant were obtained by dual regression. A Bayesian machine learning technique, called Graphical Model-based Multivariate Analysis, was applied to determine ICN regions that characterized group differences...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28888081/study-of-the-sleep-quality-and-psychological-state-of-patients-with-hepatitis-b-liver-cirrhosis
#8
Guoqing Xiao, Qing Ye, Tao Han, Junqing Yan, Lixia Sun, Fengmei Wang
We aimed to investigate the sleep quality, mild hepatic encephalopathy, anxiety and depression in patients with hepatitis B cirrhosis by using a variety of scales and questionnaires. A cohort of 341 patients with hepatitis B liver cirrhosis were categorized by Child-Pugh grading (A, B, and C) in this cross-sectional study. Pittsburgh Sleep Quality Index (PSQI), Number Connection Test-A (NCT-A), and Hospital Anxiety and Depression (HAD) evaluated the questionnaires and statistically analyzed the intrinsic correlation...
September 9, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28840059/dopamine-burden-induced-the-inactivation-of-sonic-hedgehog-signaling-to-cognitive-decline-in-minimal-hepatic-encephalopathy
#9
Saidan Ding, Jianjing Yang, Xueli Huang, Leping Liu, Jiangnan Hu, Zhu Xu, Qichuan Zhuge
Minimal hepatic encephalopathy (MHE) is induced by elevated intracranial dopamine (DA). The relationship of the Shh pathway with memory loss in MHE, however, is elusive. In the current study, rats with MHE induced with DA displayed downregulation of the Shh pathway. Additionally, injection of Shh into MHE/DA-treated rats reversed downregulation of BDNF/NT3, whereas administration of cyclopamine (Cyc) enhanced the inhibition of expression of BDNF/NT3. Furthermore, naringin (Nrg) substantially prevented cognitive impairment in MHE/DA-treated rats and upregulated the Shh pathway, paralleling the elevated expression of BDNF/NT3...
July 2017: Aging and Disease
https://www.readbyqxmd.com/read/28805273/neurotoxicosis-in-horses-associated-with-consumption-of-trema-micrantha
#10
M P Lorenzett, P R Pereira, D M Bassuino, G Konradt, W Panziera, M V Bianchi, F F Argenta, M E Hammerschmitt, R A Caprioli, C S L de Barros, S P Pavarini, D Driemeier
BACKGROUND: Trema micrantha is a tree widely distributed throughout the Americas. The tree produces highly palatable leaves that have been associated with natural poisoning in goats, sheep and horses, in which hepatic necrosis and hepatic encephalopathy have been observed. OBJECTIVES: This study describes malacia and haemorrhage in the central nervous system (CNS) due to T. micrantha consumption, with minimal to absent hepatic lesions. STUDY DESIGN: Retrospective case series...
August 14, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28796283/flumazenil-versus-placebo-or-no-intervention-for-people-with-cirrhosis-and-hepatic-encephalopathy
#11
REVIEW
Ee Teng Goh, Mette L Andersen, Marsha Y Morgan, Lise Lotte Gluud
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically 'indiscernible' or minimal hepatic encephalopathy to the clinically 'obvious' or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition site. Flumazenil may benefit people with hepatic encephalopathy through an indirect negative allosteric modulatory effect on gamma-aminobutyric acid receptor function...
August 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28776344/validation-of-a-paper-and-pencil-test-battery-for-the-diagnosis-of-minimal-hepatic-encephalopathy-in-korea
#12
Jae Yoon Jeong, Dae Won Jun, Daiseg Bai, Ji Yean Kim, Joo Hyun Sohn, Sang Bong Ahn, Sang Gyune Kim, Tae Yeob Kim, Hyoung Su Kim, Soung Won Jeong, Yong Kyun Cho, Do Seon Song, Hee Yeon Kim, Young Kul Jung, Eileen L Yoon
The aim of this study was to validate a new paper and pencil test battery to diagnose minimal hepatic encephalopathy (MHE) in Korea. A new paper and pencil test battery was composed of number connection test-A (NCT-A), number connection test-B (NCT-B), digit span test (DST), and symbol digit modality test (SDMT). The norm of the new test was based on 315 healthy individuals between the ages of 20 and 70 years old. Another 63 healthy subjects (n = 31) and cirrhosis patients (n = 32) were included as a validation cohort...
September 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28770516/hepatic-encephalopathy-a-critical-current-review
#13
REVIEW
Anna Hadjihambi, Natalia Arias, Mohammed Sheikh, Rajiv Jalan
Hepatic encephalopathy (HE) is a serious neuropsychiatric complication of cirrhosis and/or porto-systemic shunting. The clinical symptoms are widely variable, extending from subtle impairment in mental state to coma. The utility of categorizing the severity of HE accurately and efficiently serves not only to provide practical functional information about the current clinical status of the patient but also gives valuable prognostic information. In the past 20-30 years, there has been rapid progress in understanding the pathophysiological basis of HE; however, the lack of direct correlation between pathogenic factors and the severity of HE make it difficult to select appropriate therapy for HE patients...
August 2, 2017: Hepatology International
https://www.readbyqxmd.com/read/28768371/minimal-hepatic-encephalopathy-identifies-patients-at-risk-of-faster-cirrhosis-progression
#14
Javier Ampuero, Carmina Montoliú, Macarena Simón-Talero, Virginia Aguilera, Raquel Millán, Celina Márquez, Rodrigo Jover, María Carmen Rico, Carmen Sendra, Miguel Ángel Serra, Manuel Romero-Gómez
BACKGROUND &AIM: Minimal hepatic encephalopathy (MHE) predicts poor prognosis and could reflect an advanced liver disease. We aimed to assess whether MHE could be a surrogate marker of a further liver disease. METHODS: Prospective multicenter study including 320 cirrhotic patients, followed for up to 5 years, which were classified at baseline in: compensated cirrhosis without (stage 1) and with varices (stage 2), one decompensating event (stage 3), any second decompensating event (stage 4)...
August 2, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28751644/minimal-hepatic-encephalopathy-is-associated-with-expansion-and-activation-of-cd-4-cd28-th22-and-tfh-and-b-lymphocytes
#15
Alba Mangas-Losada, Raquel García-García, Amparo Urios, Desamparados Escudero-García, Joan Tosca, Remedios Giner-Durán, Miguel Angel Serra, Carmina Montoliu, Vicente Felipo
Peripheral inflammation acts synergistically with hyperammonemia in inducing neurological alterations in cirrhotic patients with minimal hepatic encephalopathy (MHE). We hypothesized that appearance of MHE would be associated to some specific qualitative change in peripheral inflammation. The aim of this work was to characterize the changes in peripheral inflammation associated to appearance of MHE. We analyzed it by immunophenotyping and cytokine profile analysis, in cirrhotic patients without or with MHE and controls...
July 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28745801/flumazenil-versus-placebo-or-no-intervention-for-people-with-cirrhosis-and-hepatic-encephalopathy
#16
REVIEW
Ee Teng Goh, Mette L Andersen, Marsha Y Morgan, Lise Lotte Gluud
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically 'indiscernible' or minimal hepatic encephalopathy to the clinically 'obvious' or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition site. Flumazenil may benefit people with hepatic encephalopathy through an indirect negative allosteric modulatory effect on gamma-aminobutyric acid receptor function...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28743700/critical-flicker-frequency-is-diagnostic-of-minimal-hepatic-encephalopathy
#17
Serag Esmat, Nouman El Garem, Hassan Raslan, Mohamed Elfekki, Gihan A Sleem
Minimal hepatic encephalopathy may affect up to 80% of cirrhotic patients, in the absence of overt hepatic encephalopathy. The objective of the study is to evaluate the accuracy of diagnosis of minimal hepatic encephalopathy with critical flicker frequency (CFF). The study was conducted on 180 patients with post hepatitis C liver cirrhosis and on 60 healthy subjects as control. Patients and controls were divided into four groups: group 1 (60), healthy individuals as a control group; group 2 (60), patients with liver cirrhosis (Child class A); group 3 (60), patients with liver cirrhosis (Child class B); and group 4 (60), patients with liver cirrhosis (Child class C)...
July 25, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28717971/subnetwork-mining-on-functional-connectivity-network-for-classification-of-minimal-hepatic-encephalopathy
#18
Daoqiang Zhang, Liyang Tu, Long-Jiang Zhang, Biao Jie, Guang-Ming Lu
Hepatic encephalopathy (HE), as a complication of cirrhosis, is a serious brain disease, which may lead to death. Accurate diagnosis of HE and its intermediate stage, i.e., minimal HE (MHE), is very important for possibly early diagnosis and treatment. Brain connectivity network, as a simple representation of brain interaction, has been widely used for the brain disease (e.g., HE and MHE) analysis. However, those studies mainly focus on finding disease-related abnormal connectivity between brain regions, although a large number of studies have indicated that some brain diseases are usually related to local structure of brain connectivity network (i...
July 17, 2017: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/28707166/altered-dynamic-functional-connectivity-in-the-default-mode-network-in-patients-with-cirrhosis-and-minimal-hepatic-encephalopathy
#19
Hua-Jun Chen, Hai-Long Lin, Qiu-Feng Chen, Peng-Fei Liu
PURPOSE: Abnormal brain intrinsic functional connectivity (FC) has been documented in minimal hepatic encephalopathy (MHE) by static connectivity analysis. However, changes in dynamic FC (dFC) remain unknown. We aimed to identify altered dFC within the default mode network (DMN) associated with MHE. METHODS: Resting-state functional MRI data were acquired from 20 cirrhotic patients with MHE and 24 healthy controls. DMN seed regions were defined using seed-based FC analysis (centered on the posterior cingulate cortex (PCC))...
July 13, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28533911/hepatic-encephalopathy
#20
Peter Ferenci
Hepatic encephalopathy (HE) is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases. The precise pathophysiology of HE is still under discussion; the leading hypothesis focus on the role of neurotoxins, impaired neurotransmission due to metabolic changes in liver failure, changes in brain energy metabolism, systemic inflammatory response and alterations of the blood brain barrier. HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations...
May 2017: Gastroenterology Report
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