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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six quantitative psychometric tests were performed on 51 healthy subjects, 19 cirrhotic patients with subclinical hepatic encephalopathy (SHE), 32 cirrhotic patients without SHE, and 26 patients with other diseases. Strong correlations between age and the results of all the psychometric tests were observed in the healthy subjects (p less than 0.005). Sex and etiology of liver cirrhosis did not affect the test results. SHE patients, compared with non-SHE and health subjects, presented impairment in the ability to perform the tests, even in the absence of obvious clinical and electroencephalogram findings. In SHE patients, trailmaking test A (TMT A) yielded the highest frequency of abnormal values, 63%. TMT A results were abnormal in 80% of SHE patients with abnormal scores in other tests, and thus it seemed to be the most sensitive test. Liver function tests did not correlate with psychometric testing in any of the groups. Blood ammonia levels in SHE patients with abnormal TMT A scores correlated with TMT A scores (r = 0.752, p less than 0.01); this was not the case in SHE nor non-SHE patients with normal TMT A results. These data demonstrate the usefulness of psychometric tests in detecting SHE.
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PMID:Quantitative psychometric testing and subclinical hepatic encephalopathy--comparative study between encephalopathic and non-encephalopathic patients with liver cirrhosis. 673 Oct 29

Abnormality in movement initiation may partially explain psychomotor delay of cirrhotic patients, even in the absence of overt hepatic encephalopathy (HE). Therefore, the aim of this study was to determine the mechanisms of psychomotor delay observed in patients with cirrhosis in the absence of overt HE. Fourteen patients with nonalcoholic cirrhosis and 12 healthy matched control subjects underwent the lateralized readiness potential (LRP) measurement elicited by a visuospatial compatibility task (Simon task). Stimulus-triggered LRPonset reflects the time in which response is selected, while response-triggered LRP onset reflects motor execution. Cirrhotic patients showed delayed reaction times (RTs) compared to controls, particularly those with trial-making test A (TMT-A) or electroencephalogram (EEG) alterations. Stimulus-triggered LRP onset was found to be delayed in cirrhotic patients compared to controls, with a significant Group-versus-Condition interaction, showing a reduced cognitive ability to cope with interfering codes, even in patients without minimal HE (MHE). Response-triggered LRP was found to be delayed only in the patients with TMT-A or EEG alterations. In conclusion, cirrhotic patients without overt HE display a psychomotor slowing, depending first lyon response inhibition and only later accompanied by impaired motor execution.
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PMID:Impairment of response inhibition precedes motor alteration in the early stage of liver cirrhosis: a behavioral and electrophysiological study. 1638 48

Minimal hepatic encephalopathy (mHE) is characterized by some minimal unspecific alterations of cerebral functions that can only be detected by neuropsychological or neurophysiological diagnostic tests, which dysfunctions nevertheless interfere with the patient's daily living. Early recognition of these impairments may prevent the progression or delay the development of the disease to overt hepatic encephalopathy. The aim of this study was to diagnose mHE in patients with decompensated liver cirrhosis. The study was conducted in 60 patients aged 40-65, divided into two groups: experimental group and control group. Patients in the experimental group were divided into Child-Pugh groups A, B or C: 53% were classified as Child-Pugh B and 47% as Child-Pugh C. Patients were tested using three neuropsychological tests: Mini Mental Score for quick assessment of cognitive status and two tests specific for mHE changes, Trail Making Test - Part A (TMT-A) and Symbol Digit Test (SDT). Electroencephalography (EEG) was performed in all patients. Limits for completing the test were set by using the formula X(control group) + 2 SD for TMT-A and X(control group) - 2 SD for SDT. All the three tests disclosed statistically significantly different results between the two groups. All patients with cirrhosis had some changes in EEG. Study results showed 80% of cirrhosis patients to have signs of mHE. The Child-Pugh score influenced performance on the neuropsychological tests. SDT more readily identified patients with mHE. Our findings pointed to the frequency of mHE and the importance of early diagnosis in the prevention of mHE progression to overt hepatic encephalopathy.
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PMID:Minimal hepatic encephalopathy in patients with decompensated liver cirrhosis. 2238 73