Trial reportPloS one2017
The continuous reaction time test for minimal hepatic encephalopathy validated by a randomized controlled multi-modal intervention-A pilot study.
Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 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
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Chinese guidelines on management of hepatic encephalopathy in cirrhosis.World journal of gastroenterology · 2019Guideline
- Minimal Hepatic Encephalopathy: A Narrative Review.Cureus · 2026Review
- Impact of liver cirrhosis etiology on results of diagnostic tests for minimal hepatic encephalopathy.Scientific reports · 2026Observational
- The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus.Hepatology communications · 2026Article
- Minimal hepatic encephalopathy: Characteristics and comparison of the main diagnostic modalities.Clinical and experimental hepatology · 2024Review
- Psychometric methods for diagnosing and monitoring minimal hepatic encephalopathy -current validation level and practical use.Metabolic brain disease · 2022Review
- Reaction Times among Batik Workers: The Influence of Gender and Occupational Lead Exposure.International journal of environmental research and public health · 2021Observational
- Standardization of the psychometric hepatic encephalopathy score in a French population.PloS one · 2021Article
- Validation of a Simple Quality-of-Life Score for Identification of Minimal and Prediction of Overt Hepatic Encephalopathy.Hepatology communications · 2020Article
- Liver Cirrhosis and Sarcopenia from the Viewpoint of Dysbiosis.International journal of molecular sciences · 2020Review
- Cerebral water content mapping in cirrhosis patients with and without manifest HE.Metabolic brain disease · 2019Article
- Article
- MHE Testing in Real World Scenario.Journal of clinical and experimental hepatology · 2018Review
- [Guidelines for the diagnosis and management of hepatic encephalopathy in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMinimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, a lack of clarity exists as to whether the tests are in fact able to detect changes in cognition.
aimTo examine if the continuous reaction time test (CRT) can detect changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE).
methodsFirstly, we conducted a reproducibility analysis and secondly measured change in CRT induced by anti-HE treatment in a randomized controlled pilot study: We stratified 44 patients with liver cirrhosis and without clinically manifest HE according to a normal (n = 22) or abnormal (n = 22) CRT. Each stratum was then block randomized to receive multimodal anti-HE intervention (lactulose+branched-chain amino acids+rifaximin) or triple placebos for 3 months in a double-blinded fashion. The CRT is a simple PC-based test and the test result, the CRT index (normal threshold > 1.9), describes the patient's stability of alertness during the 10-minute test. Our study outcome was the change in CRT index in each group at study exit. The portosystemic encephalopathy (PSE) test, a paper-and-pencil test battery (normal threshold above -5), was used as a comparator test according to international guidelines.
resultsThe patients with an abnormal CRT index who were randomized to receive the active intervention normalized or improved their CRT index (mean change 0.92 ± 0.29, p = 0.01). Additionally, their PSE improved (change 3.85 ± 1.83, p = 0.03). There was no such effect in any of the other study groups.
conclusionIn this cohort of patients with liver cirrhosis and no manifest HE, the CRT identified a group in whom cognition improved with intensive anti-HE intervention. This finding infers that the CRT can detect a response to treatment and might help in selecting patients for treatment.
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