Effects of anti-viral therapy and HCV clearance on cerebral metabolism and cognition
| Autor: | Erin Hill, Damien Lowry, Cheryl S. Weinstein, Anne Miller, Nezam H. Afdhal, Valerie Byrnes, David C. Alsop, Robert E. Lenkinski |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
medicine.medical_specialty Magnetic Resonance Spectroscopy Neuropsychological Tests Verbal learning Antiviral Agents Gastroenterology Basal Ganglia Choline Polyethylene Glycols chemistry.chemical_compound Cognition Pegylated interferon Surveys and Questionnaires Internal medicine Ribavirin Basal ganglia medicine Humans Prospective Studies Aged Aspartic Acid Hepatology business.industry Hepatitis C Hepatitis C Chronic Middle Aged Hepatitis B Creatine medicine.disease Virology Frontal Lobe chemistry Interferons Cognition Disorders business Neurocognitive Inositol medicine.drug Delis–Kaplan Executive Function System |
| Zdroj: | Journal of Hepatology. 56:549-556 |
| ISSN: | 0168-8278 |
| DOI: | 10.1016/j.jhep.2011.09.015 |
| Popis: | Background & Aims Chronic hepatitis C virus (HCV) infection is associated with altered cerebral metabolism and cognitive dysfunction. We aimed to evaluate the effect of pegylated interferon/ribavirin (PIFN/R) and HCV clearance on cerebral metabolism, and neuropsychological performance. Methods Fifteen non-cirrhotic HCV positive subjects underwent 1 H MR spectroscopy (MRS) before, during, and after treatment with PIFN/R. The metabolites of interest namely, N -acetylaspartate (NAA), choline (Cho), myo-inositol (MI), and the control metabolite creatine (Cr), were acquired from 3 different brain regions; left basal ganglia, left frontal cortex, and left dorso-lateral pre-frontal cortex. Coinciding with this, subjects also underwent a battery of neuropsychological tests to evaluate the domains of verbal learning, memory, attention, language, executive functioning, and motor skills. Seven HCV positive controls (not receiving anti-viral therapy) underwent MRS and neuropsychological testing at two time points, 12weeks apart, to examine for variation in cerebral metabolites over time and the practice effect of repeat neuropsychological testing. Results Significant reductions in basal ganglia Cho/Cr ( p =0.03) and basal ganglia MI/Cr ( p =0.03) were observed in sustained virological responders (SVRs, n=8), but not non-responders/relapsers (NR/R, n=6), indicative of reduced cerebral infection and/or immune activation in those who cleared virus. SVRs demonstrated significant improvements in verbal learning, memory, and visuo-spatial memory. A small but significant improvement in neurocognitive function secondary to the practice effect was seen in both HCV controls and HCV subjects during treatment. Conclusions HCV eradication has a beneficial effect on cerebral metabolism and selective aspects of neurocognitive function and is an important factor when contemplating anti-viral therapy in HCV, especially in those with mild disease. |
| Databáze: | OpenAIRE |
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