ArticleClinical and translational gastroenterology2015
Reversal of Low-Grade Cerebral Edema After Lactulose/Rifaximin Therapy in Patients with Cirrhosis and Minimal Hepatic Encephalopathy.
Article in Clinical and translational gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 39 citations in OpenAlex.
- The RIVET RCT: Rifamycin SV MMX improves muscle mass, physical function, and ammonia in cirrhosis and minimal encephalopathy.Hepatology communications · 2024Trial
- Brain Training with Video Games in Covert Hepatic Encephalopathy.The American journal of gastroenterology · 2017Trial
- Covert hepatic encephalopathy as a multi-organ syndrome: the gut-liver-muscle-brain axis, diagnosis, treatment, and multidisciplinary care.Journal of gastroenterology · 2026Review
- Minimal Hepatic Encephalopathy: A Narrative Review.Cureus · 2026Review
- Imaging progenitor cell differentiation during central nervous system remyelination using an MRI gene reporter.bioRxiv : the preprint server for biology · 2025Article
- Review
- Minimal Hepatic Encephalopathy Affects Daily Life of Cirrhotic Patients: A Viewpoint on Clinical Consequences and Therapeutic Opportunities.Journal of clinical medicine · 2022Review
- Psychometric methods for diagnosing and monitoring minimal hepatic encephalopathy -current validation level and practical use.Metabolic brain disease · 2022Review
- Interplay of cardiovascular mediators, oxidative stress and inflammation in liver disease and its complications.Nature reviews. Cardiology · 2021Review
- The Direct Contribution of Astrocytes and Microglia to the Pathogenesis of Hepatic Encephalopathy.Journal of clinical and translational hepatology · 2019Review
- Cerebral water content mapping in cirrhosis patients with and without manifest HE.Metabolic brain disease · 2019Article
- Application of tabu search-based Bayesian networks in exploring related factors of liver cirrhosis complicated with hepatic encephalopathy and disease identification.Scientific reports · 2019Article
- Diagnosis of covert hepatic encephalopathy: a multi-center study testing the utility of single versus combined testing.Metabolic brain disease · 2019Article
- Understanding the impact of neurologic complications in patients with cirrhosis.SAGE open medicine · 2019Review
- Pathogenesis of Hepatic Encephalopathy in Chronic Liver Disease.Journal of clinical and experimental hepatology · 2018Review
- Brain Integrity Changes Underlying Cognitive and Functional Recovery Postliver Transplant Continue to Evolve Over 1 Year.Transplantation · 2018Article
- METH-Induced Neurotoxicity Is Alleviated by Lactulose Pretreatment Through Suppressing Oxidative Stress and Neuroinflammation in Rat Striatum.Frontiers in neuroscience · 2018Article
- Characterization of Cerebral Edema in Acute-on-Chronic Liver Failure.Journal of clinical and experimental hepatology · 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
- Clinical effects of joint application of β-sodium aescinate and mannitol in treating early swelling after upper limb trauma surgery.Experimental and therapeutic medicine · 2016Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDecreased magnetization transfer ratio (MTR) in the brain characterizes cerebral edema (CE) in patients with liver cirrhosis, but the role of treatment on its reversibility has not been studied in patients who have minimal hepatic encephalopathy (MHE). This study was carried to evaluate the reversibility of CE with lactulose and rifaximin treatment in patients with MHE and role of ammonia, pro-inflammatory interleukins (IL-1, IL-6) and tumor necrosis factor (TNF)-α in its pathogenesis.
methodsTwenty-three patients with cirrhosis (14 with MHE, 9 without MHE (NMHE)) and 6 healthy controls underwent ammonia, IL-1, IL-6, TNF-α estimation, and MTR in frontal white matter (FWM), parietal white matter (PWM), internal capsule (IC), and basal ganglia (BG).
resultsAmmonia was significantly higher in the cirrhosis group compared with controls and in MHE compared with the NMHE group. Ammonia correlated positively with IL-1 and IL-6. MTRs in FWM, PWM, IC, and BG were significantly lower in the MHE group compared with controls and in PWM, IC, and BG compared with the NMHE group. MHE patients showed significant MTR increase in FWM, PWM, and IC with treatment. IL-6 and ammonia had significant negative and significant positive psychometric hepatic encephalopathy score (PHES) correlation with MTR in various regions.
conclusionsThis study, for the first time, demonstrated the reversibility of low-grade CE with treatment in patients with MHE. Negative correlation between ammonia, IL-6 levels, and MTR and positive correlation between PHES and MTR in MHE patients suggests the role of inflammation and ammonia in the genesis of low-grade CE.
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What OpenQuestion holds
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.