Regional gray matter abnormality in hepatic myelopathy patients after transjugular intrahepatic portosystemic shunt: a voxel-based morphometry study
| Autor: | Jian-Jun Ye, Gang Chen, Tianlei Yu, Guohong Han, Chen Li, Ping Tian, Yuanqiang Zhu, Yi-Bin Xi, Kang Liu, Zhengyu Wang, Shu-Yao Ren, Hong Yin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty portosystemic shunt hepatic myelopathy hepatic encephalopathy magnetic resonance imaging gray matter lower limb Fugl-Meyer Assessment basal ganglia caudate nucleus voxel-based morphometry medicine.medical_treatment Caudate nucleus lcsh:RC346-429 03 medical and health sciences Myelopathy 0302 clinical medicine Developmental Neuroscience medicine Hepatic encephalopathy lcsh:Neurology. Diseases of the nervous system medicine.diagnostic_test business.industry Putamen Magnetic resonance imaging Voxel-based morphometry medicine.disease 030104 developmental biology Radiology Portosystemic shunt business Transjugular intrahepatic portosystemic shunt 030217 neurology & neurosurgery Research Article |
| Zdroj: | Neural Regeneration Research Neural Regeneration Research, Vol 14, Iss 5, Pp 850-857 (2019) |
| ISSN: | 1876-7958 1673-5374 |
| Popis: | Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy (hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy (non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula (P = 0.003), left thalamus (P = 0.029), left superior frontal gyrus (P = 0.006), and right middle cingulate cortex (P = 0.021), and increased volume in the right caudate nucleus (P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment (r = -0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found predominantly involved motor-related regions, and may be associated with motor dysfunction. An enlarged right caudate nucleus might help to predict weak lower limb motor performance in patients with preclinical hepatic myelopathy after transjugular intrahepatic portosystemic shunt. This study was approved by the Ethics Committee of Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), China (approval No. 20140227-6) on February 27, 2014. |
| Databáze: | OpenAIRE |
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