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The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study
PURPOSE: To evaluate the effect of hepatic encephalopathy (HE), hepatic failure, and portosystemic shunt (PS) on the brain volume alteration in cirrhotic patients with MRI voxel-based morphometry (VBM). METHODS: Sixty cirrhotic patients (overt HE [OHE], n = 11; minimal HE [MHE], n = 19; non HE [nHE]...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418273/ https://www.ncbi.nlm.nih.gov/pubmed/22912746 http://dx.doi.org/10.1371/journal.pone.0042824 |
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author | Zhang, Long Jiang Qi, Rongfeng Zhong, Jianhui Xu, Qiang Zheng, Gang Lu, Guang Ming |
author_facet | Zhang, Long Jiang Qi, Rongfeng Zhong, Jianhui Xu, Qiang Zheng, Gang Lu, Guang Ming |
author_sort | Zhang, Long Jiang |
collection | PubMed |
description | PURPOSE: To evaluate the effect of hepatic encephalopathy (HE), hepatic failure, and portosystemic shunt (PS) on the brain volume alteration in cirrhotic patients with MRI voxel-based morphometry (VBM). METHODS: Sixty cirrhotic patients (overt HE [OHE], n = 11; minimal HE [MHE], n = 19; non HE [nHE], n = 30) including 12 with pre- and post-transjugular intrahepatic portosystemic shunt (TIPS) scanning and 40 healthy controls were recruited. Neuropsychological and laboratory tests were performed in all patients. VBM was analyzed with ANOVA test among 4 groups, and t-tests for patients with different hepatic function, PS scores, and TIPS. Multiple linear regression was performed to investigate the effect of venous blood ammonia levels, Child-Pugh scores, and PS on the brain volumes in all patients. RESULTS: Cirrhotic patients exhibited decreased volume in many areas of gray matter (GM), increased volume in thalamus, and increased whiter matter (WM) volume, with the extent of affected brain volume greater in HE patients than nHE patients. Hepatic failure also resulted in decreased GM volume. Patients with high PS scores and TIPS displayed decreased GM and increased WM volume in some regions. Post-TIPS patients displayed increased GM volume in the thalamus. Multiple covariate regression results suggested that Child-Pugh score was a major factor to affect GM volume, while PS mainly affected WM volume. CONCLUSION: Brain structure abnormalities appeared bilaterally symmetrical in cirrhotic patients, and the impairment was more extensive in HE patients than those without HE. Increased thalamus volume was not associated with HE progression. Hepatic failure and PS altered cirrhotic patients’ brain structure. |
format | Online Article Text |
id | pubmed-3418273 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-34182732012-08-21 The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study Zhang, Long Jiang Qi, Rongfeng Zhong, Jianhui Xu, Qiang Zheng, Gang Lu, Guang Ming PLoS One Research Article PURPOSE: To evaluate the effect of hepatic encephalopathy (HE), hepatic failure, and portosystemic shunt (PS) on the brain volume alteration in cirrhotic patients with MRI voxel-based morphometry (VBM). METHODS: Sixty cirrhotic patients (overt HE [OHE], n = 11; minimal HE [MHE], n = 19; non HE [nHE], n = 30) including 12 with pre- and post-transjugular intrahepatic portosystemic shunt (TIPS) scanning and 40 healthy controls were recruited. Neuropsychological and laboratory tests were performed in all patients. VBM was analyzed with ANOVA test among 4 groups, and t-tests for patients with different hepatic function, PS scores, and TIPS. Multiple linear regression was performed to investigate the effect of venous blood ammonia levels, Child-Pugh scores, and PS on the brain volumes in all patients. RESULTS: Cirrhotic patients exhibited decreased volume in many areas of gray matter (GM), increased volume in thalamus, and increased whiter matter (WM) volume, with the extent of affected brain volume greater in HE patients than nHE patients. Hepatic failure also resulted in decreased GM volume. Patients with high PS scores and TIPS displayed decreased GM and increased WM volume in some regions. Post-TIPS patients displayed increased GM volume in the thalamus. Multiple covariate regression results suggested that Child-Pugh score was a major factor to affect GM volume, while PS mainly affected WM volume. CONCLUSION: Brain structure abnormalities appeared bilaterally symmetrical in cirrhotic patients, and the impairment was more extensive in HE patients than those without HE. Increased thalamus volume was not associated with HE progression. Hepatic failure and PS altered cirrhotic patients’ brain structure. Public Library of Science 2012-08-13 /pmc/articles/PMC3418273/ /pubmed/22912746 http://dx.doi.org/10.1371/journal.pone.0042824 Text en © 2012 Zhang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Zhang, Long Jiang Qi, Rongfeng Zhong, Jianhui Xu, Qiang Zheng, Gang Lu, Guang Ming The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study |
title | The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study |
title_full | The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study |
title_fullStr | The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study |
title_full_unstemmed | The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study |
title_short | The Effect of Hepatic Encephalopathy, Hepatic Failure, and Portosystemic Shunt on Brain Volume of Cirrhotic Patients: A Voxel-Based Morphometry Study |
title_sort | effect of hepatic encephalopathy, hepatic failure, and portosystemic shunt on brain volume of cirrhotic patients: a voxel-based morphometry study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418273/ https://www.ncbi.nlm.nih.gov/pubmed/22912746 http://dx.doi.org/10.1371/journal.pone.0042824 |
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