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Reduced resting state connectivity and gray matter volume correlate with cognitive impairment in minimal hepatic encephalopathy.

Reduced resting state connectivity and gray matter volume correlate with cognitive impairment in minimal hepatic encephalopathy.
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García-García R, Cruz-Gómez ÁJ, Mangas-Losada A, Urios A, Forn C, Escudero-García D, Kosenko E, Ordoño JF, Tosca J, Giner-Durán R, Serra MA, Avila C, Belloch V, Felipo V, Montoliu C,


García-García R, Cruz-Gómez ÁJ, Mangas-Losada A, Urios A, Forn C, Escudero-García D, Kosenko E, Ordoño JF, Tosca J, Giner-Durán R, Serra MA, Avila C, Belloch V, Felipo V, Montoliu C, (click to view)

García-García R, Cruz-Gómez ÁJ, Mangas-Losada A, Urios A, Forn C, Escudero-García D, Kosenko E, Ordoño JF, Tosca J, Giner-Durán R, Serra MA, Avila C, Belloch V, Felipo V, Montoliu C,

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PloS one 2017 10 1212(10) e0186463 doi 10.1371/journal.pone.0186463
Abstract
BACKGROUND AND AIMS
Minimal hepatic encephalopathy (MHE) is associated with cognitive alterations and changes in connectivity. We assessed the relationship of the abnormalities of resting-state functional connectivity (rs-FC) and gray matter (GM) volume with different cognitive alterations and biochemical parameters associated to MHE.

METHODS
Thirty-nine cirrhotic patients (26 without and 13 with MHE) and 24 controls were widely cognitive assessed with a battery of psychometric tests. Atrophy was determined using Voxel-Based Morphometry and rs-FC was assessed by independent component analysis. Receiver operating characteristic (ROC) curves was performed to assess the diagnostic utility of rs-FC and GM reduction for the discrimination of patients with and without MHE. Blood ammonia, cGMP, and levels of pro-inflammatory interleukins were measured.

RESULTS
MHE patients showed significant decrease of GM volume and lesser degree of rs-FC in different networks related to attention and executive functions as compared to controls and patients without MHE. There is a progressive reduction in rs-FC in the default mode network with the progression of cognitive impairment. MHE patients showed GM reduction in the right frontal lobe, right insula and right cerebellum compared to patients without MHE. Alterations in GM volume and rs-FC correlated with the scores of different cognitive tests.

CONCLUSIONS
Decreased cognitive performance is associated by reduced rs-FC and GM atrophy in MHE patients. These changes could have predictive value for detecting MHE.

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