Trial reportMetabolic brain disease2014
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.
Trial report in Metabolic brain disease, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Pooled it
- Gut-brain axis and neuroplasticity in health and disease: a systematic review.La Radiologia medica · 2025Pooled it
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis.Frontiers in neuroscience · 2021Pooled it
- Gut microbiota, cognitive frailty and dementia in older individuals: a systematic review.Clinical interventions in aging · 2018Pooled it
- Effects of the antibiotic rifaximin on cortical functional connectivity are mediated through insular cortex.Scientific reports · 2021Trial
- Effects of Rifaximin on Central Responses to Social Stress-a Pilot Experiment.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2018Trial
- Brain Training with Video Games in Covert Hepatic Encephalopathy.The American journal of gastroenterology · 2017Trial
- Minimal Hepatic Encephalopathy: A Narrative Review.Cureus · 2026Review
- Rifaximin's therapeutic spectrum: approved indications and experimental insights into emerging uses.Pharmacological reports : PR · 2026Review
- Microbial Approaches to Treat and Prevent Hepatic Encephalopathy.Gastroenterology clinics of North America · 2025Review
- Gut microbiota and their influence in brain cancer milieu.Journal of neuroinflammation · 2025Review
- Gut Microbiota Modulation of Dementia Related Complications.Aging and disease · 2025Review
- Evidence Suggesting Prolonged Neuroinflammation in a Subset of Children after Moderate/Severe TBI: A UCLA RAPBI Study.medRxiv : the preprint server for health sciences · 2025Article
- The effects of rifaximin and lactulose on the gut-liver-brain axis in rats with minimal hepatic encephalopathy.PloS one · 2025Article
- Mendelian randomization study reveals causal effects of specific gut microbiota on the risk of interstitial cystitis/bladder pain syndrome (IC/BPS).Scientific reports · 2024Article
- Working Memory in Patients with Varying Degree of Hepatic Encephalopathy (HE): A Pilot EEG-fNIRS Study.Neurochemical research · 2024Article
- Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study.World journal of hepatology · 2024Article
- Improved cognition after rifaximin treatment is associated with changes in intra- and inter-brain network functional connectivity.Journal of translational medicine · 2024Article
- Cognotoxemia: endotoxemia and gender predict changes in working memory performance in healthy adults.Frontiers in neuroscience · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 3 institutions in 1 country.
Funding
Abstract
unlabelledMinimal hepatic encephalopathy (MHE) impairs daily functioning in cirrhosis, but its functional brain impact is not completely understood. To evaluate the effect of rifaximin, a gut-specific antibiotic, on the gut-liver-brain axis in MHE. HYPOTHESIS: Rifaximin will reduce endotoxemia, enhance cognition, increase activation during working memory(N-back) and reduce activation needed for inhibitory control tasks.
methodsCirrhotics with MHE underwent baseline endotoxin and cognitive testing, then underwent fMRI, diffusion tensor imaging and MR spectroscopy(MRS). On fMRI, two tasks; N-back (outcome: correct responses) and inhibitory control tests(outcomes: lure inhibition) were performed. All procedures were repeated after 8 weeks of rifaximin. RESULTS were compared before/after rifaximin.
results20 MHE patients (59.7 years) were included; sixteen completed pre/post-rifaximin scanning with 92% medication compliance. Pre-rifaximin patients had cognitive impairment. At trial-end, there was a significantly higher correct 2-back responses, ICT lure inhibitions and reduced endotoxemia(p = 0.002). This was accompanied by significantly higher activation from baseline in subcortical structures (thalamus, caudate, insula and hippocampus) and left parietal operculum (LPO) during N-back, decrease in fronto-parietal activation required for inhibiting lures, including LPO during ICT compared to baseline values. Connectivity studies in N-back showed significant shifts in linkages after therapy in fronto-parietal regions with a reduction in fractional anisotropy (FA) but not mean diffusivity (MD), and no change in MRS metabolites at the end of the trial. A significant improvement in cognition including working memory and inhibitory control, and fractional anisotropy without effect on MD or MRS, through modulation of fronto-parietal and subcortical activation and connectivity was seen after open-label rifaximin therapy in MHE.
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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.