Combining arterial-spin labeling with functional MRI measurement for characterizing patients with minimal hepatic encephalopathy.

Hepatol Res. 2016 Oct 7;:

Authors: Li Y, Liu H, Yang J, Tian X, Yang H, Geng Z

Abstract
AIM: Our objective is to explore key changes in brain functions in relation to minimal hepatic encephalopathy (MHE). Moreover, we incorporated both resting-state functional MRI (fMRI) and arterial spin labeling (ASL) to enhance the detection of MHE.
METHODS: We conducted fMRI scanning for 56 MHE patients and 66 healthy controls. Region functional connectivity (FC) was carried out to assess the connectivity status between pair of regions among 90 brain regions. Additionally, blood flood (BF) status was measured by ASL for all subjects. Furthermore, the Spearman correlation test was implemented to identify any correlation among z-values, results from number connection test type A (NCT-A) and digit symbol test (DST). Finally, the receiver operating characteristic curve (ROC) was generated for assessing the accuracy of BF in MHE diagnosis.
RESULTS: The corresponding FC was significantly different between MHE and control group in 15 regions. For MHE patients, BF exhibited an increasing pattern in regions of interest (ROI). BF in the putamen was positively correlated with NCT-A neuropsychological performance whereas it was negatively correlated with DST. BF in the right putamen exhibited the highest value of area under the curve with a sensitivity of 85.7% and specificity of 89.4%.
CONCLUSION: Connectivity impairment resulted from ganglia-thalamo-cortical circuit may play important roles in mediating the development of MHE patients. An increase in the BF particularly in the right putamen may be considered as evidence for the presence of MHE.

PMID: 27717156 [PubMed - as supplied by publisher]