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Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy

Background: Minimal hepatic encephalopathy (MHE) refers to a number of neuropsychiatric and neurophysiological disorders in patients with cirrhosis who do not show abnormalities on physical examination or in clinical tests. The aim of this study was to determine the prevalence, risk factors, and pre...

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Autores principales: Stawicka, Agnieszka, Jaroszewicz, Jerzy, Zbrzeźniak, Justyna, Sołowianowicz, Natalia, Woszczenko, Aleksandra, Świderska, Magdalena, Flisiak, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277853/
https://www.ncbi.nlm.nih.gov/pubmed/32455895
http://dx.doi.org/10.3390/ijerph17103645
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author Stawicka, Agnieszka
Jaroszewicz, Jerzy
Zbrzeźniak, Justyna
Sołowianowicz, Natalia
Woszczenko, Aleksandra
Świderska, Magdalena
Flisiak, Robert
author_facet Stawicka, Agnieszka
Jaroszewicz, Jerzy
Zbrzeźniak, Justyna
Sołowianowicz, Natalia
Woszczenko, Aleksandra
Świderska, Magdalena
Flisiak, Robert
author_sort Stawicka, Agnieszka
collection PubMed
description Background: Minimal hepatic encephalopathy (MHE) refers to a number of neuropsychiatric and neurophysiological disorders in patients with cirrhosis who do not show abnormalities on physical examination or in clinical tests. The aim of this study was to determine the prevalence, risk factors, and predictive value of minimal hepatic encephalopathy and the usefulness of the inhibitory control test (ICT) in the diagnosis. Methods: Seventy patients (mean age 53 years, range 24−77) with liver cirrhosis were enrolled in the study. MHE was diagnosed based on PHES (psychometric hepatic encephalopathy score) and ICT. PHES and ICT were validated in a group of 56 control subjects. Results: Minimal hepatic encephalopathy was diagnosed using PHES in 21 patients (30%). ICT diagnosed MHE in 30 patients (42%), and the test had a sensitivity of 65% and a specificity of 57% compared to PHES. The ICT score (lures/target accuracy rate) correlated with the age of subjects (R = 0.35, p = 0.002) and only slightly with education (education in years R = −0.22, p = 0.06). MHE diagnosed with PHES or ICT was associated with a significantly higher model of end-stage liver disease (MELD) score in the follow-up. MHE diagnosed with ICT was correlated with a significantly higher incidence of symptoms of decompensated cirrhosis (p = 0.02) in the follow-up. Conclusions: ICT had moderate sensitivity and specificity in diagnosing MHE compared to PHES. Importantly, MHE detected with PHES or ICT was associated with poorer survival and a more severe progression of the disease.
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spelling pubmed-72778532020-06-12 Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy Stawicka, Agnieszka Jaroszewicz, Jerzy Zbrzeźniak, Justyna Sołowianowicz, Natalia Woszczenko, Aleksandra Świderska, Magdalena Flisiak, Robert Int J Environ Res Public Health Article Background: Minimal hepatic encephalopathy (MHE) refers to a number of neuropsychiatric and neurophysiological disorders in patients with cirrhosis who do not show abnormalities on physical examination or in clinical tests. The aim of this study was to determine the prevalence, risk factors, and predictive value of minimal hepatic encephalopathy and the usefulness of the inhibitory control test (ICT) in the diagnosis. Methods: Seventy patients (mean age 53 years, range 24−77) with liver cirrhosis were enrolled in the study. MHE was diagnosed based on PHES (psychometric hepatic encephalopathy score) and ICT. PHES and ICT were validated in a group of 56 control subjects. Results: Minimal hepatic encephalopathy was diagnosed using PHES in 21 patients (30%). ICT diagnosed MHE in 30 patients (42%), and the test had a sensitivity of 65% and a specificity of 57% compared to PHES. The ICT score (lures/target accuracy rate) correlated with the age of subjects (R = 0.35, p = 0.002) and only slightly with education (education in years R = −0.22, p = 0.06). MHE diagnosed with PHES or ICT was associated with a significantly higher model of end-stage liver disease (MELD) score in the follow-up. MHE diagnosed with ICT was correlated with a significantly higher incidence of symptoms of decompensated cirrhosis (p = 0.02) in the follow-up. Conclusions: ICT had moderate sensitivity and specificity in diagnosing MHE compared to PHES. Importantly, MHE detected with PHES or ICT was associated with poorer survival and a more severe progression of the disease. MDPI 2020-05-22 2020-05 /pmc/articles/PMC7277853/ /pubmed/32455895 http://dx.doi.org/10.3390/ijerph17103645 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Stawicka, Agnieszka
Jaroszewicz, Jerzy
Zbrzeźniak, Justyna
Sołowianowicz, Natalia
Woszczenko, Aleksandra
Świderska, Magdalena
Flisiak, Robert
Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy
title Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy
title_full Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy
title_fullStr Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy
title_full_unstemmed Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy
title_short Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy
title_sort clinical usefulness of the inhibitory control test (ict) in the diagnosis of minimal hepatic encephalopathy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277853/
https://www.ncbi.nlm.nih.gov/pubmed/32455895
http://dx.doi.org/10.3390/ijerph17103645
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