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Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis

Hepatic encephalopathy (HE) is one of the most disabling metabolic diseases. It consists of a complication of liver disease through the action of neurotoxins, such as excessive production of ammonia from liver, resulting in impaired brain function. Its prevalence and incidence are not well known, al...

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Autores principales: López-Franco, Óscar, Morin, Jean-Pascal, Cortés-Sol, Albertina, Molina-Jiménez, Tania, Del Moral, Diana I., Flores-Muñoz, Mónica, Roldán-Roldán, Gabriel, Juárez-Portilla, Claudia, Zepeda, Rossana C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006450/
https://www.ncbi.nlm.nih.gov/pubmed/33790729
http://dx.doi.org/10.3389/fnins.2021.579263
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author López-Franco, Óscar
Morin, Jean-Pascal
Cortés-Sol, Albertina
Molina-Jiménez, Tania
Del Moral, Diana I.
Flores-Muñoz, Mónica
Roldán-Roldán, Gabriel
Juárez-Portilla, Claudia
Zepeda, Rossana C.
author_facet López-Franco, Óscar
Morin, Jean-Pascal
Cortés-Sol, Albertina
Molina-Jiménez, Tania
Del Moral, Diana I.
Flores-Muñoz, Mónica
Roldán-Roldán, Gabriel
Juárez-Portilla, Claudia
Zepeda, Rossana C.
author_sort López-Franco, Óscar
collection PubMed
description Hepatic encephalopathy (HE) is one of the most disabling metabolic diseases. It consists of a complication of liver disease through the action of neurotoxins, such as excessive production of ammonia from liver, resulting in impaired brain function. Its prevalence and incidence are not well known, although it has been established that up to 40% of cirrhotic patients may develop HE. Patients with HE episodes display a wide range of neurological disturbances, from subclinical alterations to coma. Recent evidence suggests that the resolution of hepatic encephalopathy does not fully restore cognitive functioning in cirrhotic patients. Therefore, the aim of this review was to evaluate the evidence supporting the presence of lingering cognitive deficits in patients with a history of HE compared to patients without HE history and how liver transplant affects such outcome in these patients. We performed two distinct meta-analysis of continuous outcomes. In both cases the results were pooled using random-effects models. Our results indicate that cirrhotic patients with a history of HE show clear cognitive deficits compared to control cirrhotic patients (Std. Mean Difference (in SDs) = −0.72 [CI 95%: −0.94, −0.50]) and that these differences are not fully restored after liver transplant (Std. Mean Difference (in SDs) = −0.48 [CI 95%: −0.77, −0.19]).
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spelling pubmed-80064502021-03-30 Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis López-Franco, Óscar Morin, Jean-Pascal Cortés-Sol, Albertina Molina-Jiménez, Tania Del Moral, Diana I. Flores-Muñoz, Mónica Roldán-Roldán, Gabriel Juárez-Portilla, Claudia Zepeda, Rossana C. Front Neurosci Neuroscience Hepatic encephalopathy (HE) is one of the most disabling metabolic diseases. It consists of a complication of liver disease through the action of neurotoxins, such as excessive production of ammonia from liver, resulting in impaired brain function. Its prevalence and incidence are not well known, although it has been established that up to 40% of cirrhotic patients may develop HE. Patients with HE episodes display a wide range of neurological disturbances, from subclinical alterations to coma. Recent evidence suggests that the resolution of hepatic encephalopathy does not fully restore cognitive functioning in cirrhotic patients. Therefore, the aim of this review was to evaluate the evidence supporting the presence of lingering cognitive deficits in patients with a history of HE compared to patients without HE history and how liver transplant affects such outcome in these patients. We performed two distinct meta-analysis of continuous outcomes. In both cases the results were pooled using random-effects models. Our results indicate that cirrhotic patients with a history of HE show clear cognitive deficits compared to control cirrhotic patients (Std. Mean Difference (in SDs) = −0.72 [CI 95%: −0.94, −0.50]) and that these differences are not fully restored after liver transplant (Std. Mean Difference (in SDs) = −0.48 [CI 95%: −0.77, −0.19]). Frontiers Media S.A. 2021-03-10 /pmc/articles/PMC8006450/ /pubmed/33790729 http://dx.doi.org/10.3389/fnins.2021.579263 Text en Copyright © 2021 López-Franco, Morin, Cortés-Sol, Molina-Jiménez, Del Moral, Flores-Muñoz, Roldán-Roldán, Juárez-Portilla and Zepeda. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
López-Franco, Óscar
Morin, Jean-Pascal
Cortés-Sol, Albertina
Molina-Jiménez, Tania
Del Moral, Diana I.
Flores-Muñoz, Mónica
Roldán-Roldán, Gabriel
Juárez-Portilla, Claudia
Zepeda, Rossana C.
Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis
title Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis
title_full Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis
title_fullStr Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis
title_full_unstemmed Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis
title_short Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis
title_sort cognitive impairment after resolution of hepatic encephalopathy: a systematic review and meta-analysis
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006450/
https://www.ncbi.nlm.nih.gov/pubmed/33790729
http://dx.doi.org/10.3389/fnins.2021.579263
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