Cerebral metabolite alterations in patients with posttransplant encephalopathy after liver transplantation
Autor: | Annemarie Goldbecker, Hannelore Barg-Hock, Anita B. Tryc, Henning Pflugrad, Karin Weissenborn, Christian P. Strassburg, Peter Raab, Heinrich Lanfermann, Jürgen Klempnauer |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Male
Central Nervous System Cirrhosis Magnetic Resonance Spectroscopy medicine.medical_treatment Liver transplantation Chronic liver disease Gastroenterology Biochemistry Nervous System Diagnostic Radiology chemistry.chemical_compound 0302 clinical medicine Thalamus Medicine and Health Sciences Metabolites Choline Brain Mapping Multidisciplinary Radiology and Imaging Liver Diseases Brain Middle Aged Magnetic Resonance Imaging Thalamic Nuclei Metabolome Medicine 030211 gastroenterology & hepatology Female Anatomy Research Article medicine.medical_specialty Lentiform nucleus Imaging Techniques Science Encephalopathy Surgical and Invasive Medical Procedures Gastroenterology and Hepatology Creatine Research and Analysis Methods Phosphocreatine 03 medical and health sciences Digestive System Procedures Diagnostic Medicine Internal medicine medicine Humans Transplantation business.industry Biology and Life Sciences Organ Transplantation medicine.disease Liver Transplantation Metabolism chemistry Case-Control Studies Hepatic Encephalopathy business 030217 neurology & neurosurgery Neuroscience |
Zdroj: | PLoS ONE, Vol 14, Iss 8, p e0221626 (2019) PLoS ONE |
ISSN: | 1932-6203 |
Popis: | BackgroundIn the first weeks after liver transplantation about 30% of the patients develop a posttransplant encephalopathy. A posttransplant encephalopathy comprises metabolic-toxic caused symptoms such as disorientation, confusion, hallucinations, cognitive dysfunction and seizures. We hypothesize that alterations of cerebral metabolites before liver transplantation predispose posttransplant encephalopathy development after liver transplantation.Methods31 patients with chronic liver disease underwent magnetic resonance spectroscopy (MRS) before liver transplantation to assess glutamine/glutamate (Glx), myo-Inositol (mI), choline (Cho), creatine/phosphocreatine- and N-acetyl-aspartate/N-acetyl-aspartate-glutamate concentrations in the thalamus, lentiform nucleus and white matter. Of these, 14 patients underwent MRS additionally after liver transplantation. Furthermore, 15 patients received MRS only after liver transplantation. Patients' data were compared to 20 healthy age adjusted controls.ResultsPatients showed significantly increased Glx and decreased mI and Cho concentrations compared to controls before liver transplantation (p≤0.01). The MRS values before liver transplantation of patients with posttransplant encephalopathy showed no significant difference compared to patients without posttransplant encephalopathy. Patients after liver transplantation showed increased Glx concentrations (p≤0.01) compared to controls, however, patients with and without posttransplant encephalopathy did not differ. Patients with posttransplant encephalopathy who underwent MRS before and after liver transplantation showed a significant mI increase in all three brain regions (pConclusionPatients with and without posttransplant encephalopathy showed no significant difference in cerebral metabolites before liver transplantation. However, the paired sub-analysis indicates that the extent of cerebral metabolite alterations in patients with liver cirrhosis might be critical for the development of posttransplant encephalopathy after liver transplantation. |
Databáze: | OpenAIRE |
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