Trial reportBMC gastroenterology2013
Mini-Mental State Examination in patients with hepatic encephalopathy and liver cirrhosis: a prospective, quantified electroencephalography study.
Trial report in BMC gastroenterology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 26 citations in OpenAlex.
- Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial.Clinical interventions in aging · 2024Trial
- Electroencephalography in hepatic encephalopathy: diagnostic and prognostic applications across the disease spectrum.Annals of gastroenterology · 2026Review
- Brand new norms for a good old test: Northern Italy normative study of MiniMental State Examination.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Differences in anxiety among patients with liver cirrhosis with different compensation abilities.American journal of translational research · 2022Article
- EEG abnormality as a prognostic factor in cirrhotic patients with Grade III-IV hepatic encephalopathy requiring mechanical ventilation: A retrospective analysis.Journal of clinical and translational research · 2021Article
- Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan.Journal of personalized medicine · 2021Article
- Article
- Frontal assessment battery: A tool for screening minimal hepatic encephalopathy?World journal of hepatology · 2016Article
- Altered metal metabolism in patients with HCV-related cirrhosis and hepatic encephalopathy.Metabolic brain disease · 2015Article
- Clinical neurophysiology of hepatic encephalopathy.Journal of clinical and experimental hepatology · 2015Review
- Covert hepatic encephalopathy: does the mini-mental state examination help?Journal of clinical and experimental hepatology · 2014Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMini-Mental State Examination (MMSE) is one of the most commonly used methods in the assessment of cognitive mental status. MMSE has been used in hepatology but its usefulness in the evaluation of hepatic encephalopathy (HE) has never been properly assessed. The aim of the study was to investigate the value of MMSE in detection of HE in patients with cirrhosis.
methodsOne hundred and one consecutive patients with liver cirrhosis underwent neurological examination, MMSE and electroencephalography (EEG). Spectral analysis of EEG was done with calculation of mean dominant frequency (MDF) and relative power of delta, theta, alpha and beta rhythms. Minimal HE was diagnosed in patients with normal neurological status and alterations in spectral EEG. Statistical analysis included Fisher's exact and Anova analysis. Categorical data were compared using Levene's test for equality of variances. Correlation-coefficient analysis was performed by the Pearson's r or Z-test, as needed. Tests performance was assessed by the calculating the area under the ROC curve (AUC) and evaluating its difference from reference area (AUC=0.5). A p value <0.05 was considered statistically significant.
resultsOvert HE was identified in 49 (48.5%) and minimal HE in 22 (21.8%) patients. Although there were significant correlations between both severity of liver disease (Child-Pugh classification), overt HE (West-Haven criteria) and various MMSE items, MDF showed no correlation with any of MMSE items as well as MMSE summary score. MMSE (score and items) did not discriminate patients without HE and minimal HE. The only significant differences between patients without HE and with overt HE were seen in respect of MMSE score (p<0.02), orientation to place (p<0.003), repetition (p<0.01) and complex commands-understanding (p<0.02). Test performance analysis has shown that MMSE has no value as a prediction method in determining minimal HE and in respect of overt HE has a sensitivity of 63% and specificity of 52% by a cut-off level at 27.5 points to diagnose overt HE.
conclusionsIn conclusion, although MMSE score and single items are altered in patients with overt HE, MMSE has no value in the assessment of minimal HE. Because MMSE could be impaired in several cognitive dysfunctions, more specific test should be used for measuring HE.
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