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Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil

Minimal hepatic encephalopathy is a syndrome caused by cirrhosis, with a broad spectrum of clinical manifestations. Its diagnosis is based on abnormal results of cognitive and neurophysiological tests, but there are no universally available criteria, especially in Brazil, where local testing standar...

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Autores principales: Torres, Daniel Simplicio, Abrantes, Jefferson, Brandão-Mello, Carlos Eduardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248115/
https://www.ncbi.nlm.nih.gov/pubmed/32451417
http://dx.doi.org/10.1038/s41598-020-65307-3
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author Torres, Daniel Simplicio
Abrantes, Jefferson
Brandão-Mello, Carlos Eduardo
author_facet Torres, Daniel Simplicio
Abrantes, Jefferson
Brandão-Mello, Carlos Eduardo
author_sort Torres, Daniel Simplicio
collection PubMed
description Minimal hepatic encephalopathy is a syndrome caused by cirrhosis, with a broad spectrum of clinical manifestations. Its diagnosis is based on abnormal results of cognitive and neurophysiological tests, but there are no universally available criteria, especially in Brazil, where local testing standards are required. The objective of the present study was to compare the performance of the mini-mental state examination (MMSE), Rey’s auditory-verbal learning test (RAVLT), psychometric score of hepatic encephalopathy (PHES), topographic mapping of brain electrical activity (TMBEA) and long-latency auditory evoked potential (P300) in the detection of minimal hepatic encephalopathy in Brazil. From 224 patients with cirrhosis included in the global sample, 82.5% were excluded due to secondary causes responsible for cognitive or neurophysiological dysfunction. The final sample consisted of 29 cirrhotics, with predominance of A5 Child-Pugh classification, and 29 controls paired in critical variables such as age, educational level, gender, professional category, scores suggestive of mild depression, association with compensated type 2 diabetes mellitus and sociodemographic characteristics. Overall, performance on cognitive tests and TMBEA did not show a statistically significant difference. There was a marked difference in P300 latency adjusted for age, with patients with cirrhosis showing a mean of 385 ± 78 ms (median of 366.6 ms) and healthy volunteers exhibiting a mean of 346.2 ± 42.8 ms (median of 348.2 ms) (p < 0.01). These findings suggest that, in the earliest stages of cirrhosis, age-adjusted P300 latency was superior to cognitive assessment and TMBEA for detection of minimal hepatic encephalopathy.
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spelling pubmed-72481152020-06-04 Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil Torres, Daniel Simplicio Abrantes, Jefferson Brandão-Mello, Carlos Eduardo Sci Rep Article Minimal hepatic encephalopathy is a syndrome caused by cirrhosis, with a broad spectrum of clinical manifestations. Its diagnosis is based on abnormal results of cognitive and neurophysiological tests, but there are no universally available criteria, especially in Brazil, where local testing standards are required. The objective of the present study was to compare the performance of the mini-mental state examination (MMSE), Rey’s auditory-verbal learning test (RAVLT), psychometric score of hepatic encephalopathy (PHES), topographic mapping of brain electrical activity (TMBEA) and long-latency auditory evoked potential (P300) in the detection of minimal hepatic encephalopathy in Brazil. From 224 patients with cirrhosis included in the global sample, 82.5% were excluded due to secondary causes responsible for cognitive or neurophysiological dysfunction. The final sample consisted of 29 cirrhotics, with predominance of A5 Child-Pugh classification, and 29 controls paired in critical variables such as age, educational level, gender, professional category, scores suggestive of mild depression, association with compensated type 2 diabetes mellitus and sociodemographic characteristics. Overall, performance on cognitive tests and TMBEA did not show a statistically significant difference. There was a marked difference in P300 latency adjusted for age, with patients with cirrhosis showing a mean of 385 ± 78 ms (median of 366.6 ms) and healthy volunteers exhibiting a mean of 346.2 ± 42.8 ms (median of 348.2 ms) (p < 0.01). These findings suggest that, in the earliest stages of cirrhosis, age-adjusted P300 latency was superior to cognitive assessment and TMBEA for detection of minimal hepatic encephalopathy. Nature Publishing Group UK 2020-05-25 /pmc/articles/PMC7248115/ /pubmed/32451417 http://dx.doi.org/10.1038/s41598-020-65307-3 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Torres, Daniel Simplicio
Abrantes, Jefferson
Brandão-Mello, Carlos Eduardo
Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil
title Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil
title_full Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil
title_fullStr Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil
title_full_unstemmed Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil
title_short Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil
title_sort cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in brazil
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248115/
https://www.ncbi.nlm.nih.gov/pubmed/32451417
http://dx.doi.org/10.1038/s41598-020-65307-3
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