ArticleNeurology2013
Modulation of neural activation following treatment of hepatic encephalopathy.
Article in Neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- L-ornithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2018Pooled it
- Enhancement of functional connectivity, working memory and inhibitory control on multi-modal brain MR imaging with Rifaximin in Cirrhosis: implications for the gut-liver-brain axis.Metabolic brain disease · 2014Trial
- Functional Network-Based Statistics Reveal Abnormal Resting-State Functional Connectivity in Minimal Hepatic Encephalopathy.Frontiers in neurology · 2019Article
- Update in Hepatic Encephalopathy.Journal of clinical and experimental hepatology · 2018Article
- Hepatic Encephalopathy and Astrocyte Senescence.Journal of clinical and experimental hepatology · 2018Review
- Multimodal MR imaging in hepatic encephalopathy: state of the art.Metabolic brain disease · 2018Review
- Predictive models of minimal hepatic encephalopathy for cirrhotic patients based on large-scale brain intrinsic connectivity networks.Scientific reports · 2017Article
- A longitudinal study of patients with cirrhosis treated with L-ornithine L-aspartate, examined with magnetization transfer, diffusion-weighted imaging and magnetic resonance spectroscopy.Metabolic brain disease · 2017Article
- Elderly patients have an altered gut-brain axis regardless of the presence of cirrhosis.Scientific reports · 2016Article
- Current state of knowledge of hepatic encephalopathy (Part V): clinical efficacy of L-ornithine-L-aspartate in the management of HE.Metabolic brain disease · 2016Review
- Identifying minimal hepatic encephalopathy in cirrhotic patients by measuring spontaneous brain activity.Metabolic brain disease · 2016Article
- Impaired Gut-Liver-Brain Axis in Patients with Cirrhosis.Scientific reports · 2016Article
- Resting-state functional magnetic resonance imaging in hepatic encephalopathy: current status and perspectives.Metabolic brain disease · 2014Review
- Multimodality magnetic resonance imaging in hepatic encephalopathy: an update.World journal of gastroenterology · 2014Review
- Spatial dependencies between large-scale brain networks.PloS one · 2014Article
- Brain Edema in Chronic Hepatic Encephalopathy.Journal of clinical and experimental hepatologyReview
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveTo measure changes in psychometric state, neural activation, brain volume (BV), and cerebral metabolite concentrations during treatment of minimal hepatic encephalopathy.
methodsAs proof of principle, 22 patients with well-compensated, biopsy-proven cirrhosis of differing etiology and previous minimal hepatic encephalopathy were treated with oral l-ornithine l-aspartate for 4 weeks. Baseline and 4-week clinical review, blood chemistry, and psychometric evaluation (Psychometric Hepatic Encephalopathy Score and Cognitive Drug Research Score) were performed. Whole-brain volumetric and functional MRI was conducted using a highly simplistic visuomotor task, together with proton magnetic resonance spectroscopy of the basal ganglia. Treatment-related changes in regional BV and neural activation change (blood oxygenation level dependent) were assessed.
resultsAlthough there was no change in clinical, biochemical state, basal ganglia magnetic resonance spectroscopy, or in regional BV, there were significant improvements in Cognitive Drug Research Score (+1.2, p = 0.003) and Psychometric Hepatic Encephalopathy Score (+1.5, p = 0.003) with treatment. This cognitive amelioration was accompanied by changes in blood oxygenation level-dependent activation in the posterior cingulate and ventral medial prefrontal cortex, 2 regions that form part of the brain's structural and metabolic core. In addition, there was evidence of greater visual cortex activation.
conclusionsThese structurally interconnected regions all showed increased function after successful encephalopathy treatment. Because no regional change in BV was observed, this implies that mechanisms unrelated to astrocyte volume regulation were involved in the significant improvement in cognitive performance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.