Clinical correlation of neuropsychological tests with 1H magnetic resonance spectroscopy in hepatic encephalopathy
| Autor: | Fawzy I. Fawzy, Barry H. Guze, M. Albert Thomas, Lynn A. Fairbanks, Mary Bugbee, Thomas B. Strouse, Amir Huda |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Glutamine Liver transplantation Neuropsychological Tests Gastroenterology Internal medicine medicine Humans Hepatic encephalopathy Applied Psychology Subclinical infection Brain Diseases medicine.diagnostic_test business.industry Magnetic resonance imaging Neuropsychological test Middle Aged medicine.disease Creatine Magnetic Resonance Imaging Acetylcholine Transplantation Psychiatry and Mental health Frontal lobe Hepatic Encephalopathy Female Psychomotor Disorders business Psychomotor disorder Inositol |
| Zdroj: | Psychosomatic medicine. 60(5) |
| ISSN: | 0033-3174 |
| Popis: | Objective The purpose of this project was to correlate neuropsychological test results with in vivo measures of regional cerebral biochemistry determined by 1H MRS in patients with subclinical and mild hepatic encephalopathy. Methods Baseline 1H MRS scans and neuropsychological testing of patients occurred at entry into the study. The primary localized volume chosen for the 1H MRS study was the posteromedial parietal cortex, which consisted predominantly of white matter. Some of these patients were scanned again if they received a liver transplantation. In a subset of patients, the effect on cerebral biochemistry and neuropsychological test performance due to a dietary intervention of reduced protein intake was monitored. These patients underwent a baseline examination and a repeat examination after 2 weeks of dietary intervention. Measures were made of the correlation between the dietary intervention and 1H MRS determined biochemistry and the results of neuropsychological tests. Results in both patient groups (dietary intervention and no dietary intervention) were compared with healthy control subjects. Results Subclinical and low grade HE patients showed a significant reduction in mI/Cr and Cho/Cr ratio when compared with healthy control subjects. These patients also showed impairment in frontal lobe mediated cognitive tasks and in motor ability that were not appreciated in a bedside examination. The patients did not return to normal cerebral metabolic states within 30 to 60 days of liver transplantation. In fact, reductions remained in mI/Cr. Cho/Cr values increased after transplantation compared with healthy control subjects. Conclusions 1H MRS studies showed changes in regional cerebral biochemistry associated with all grades of HE. There was a reduction in mI/Cr and a reduction in Cho/Cr in patients with low grade and subclinical forms of HE compared with normal subjects. The reduction in mI correlated well with abnormalities observed in neuropsychological tests. Liver transplantation was not associated with significant improvement in these variables. |
| Databáze: | OpenAIRE |
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