Cognitive Functions in Patients with Liver Cirrhosis: a Tendency to Commit More Memory Errors

Overview

Journal Med Sci Monit

Specialties General Medicine
Pathology

Date 2013 Apr 20

PMID 23598598

Citations 10

Authors

Irena Ciecko-Michalska

Jan Wojcik

Magdalena Senderecka

Miroslaw Wyczesany

Marek Binder

Jakub Szewczyk

Tomasz Dziedzic

Agnieszka Slowik

Tomasz Mach

Affiliations

Soon will be listed here.

Abstract

Background: Minimal hepatic encephalopathy (MHE) is the mildest form of hepatic encephalopathy (HE). For diagnostic purposes, 2 alternative batteries of psychometric screening tests are recommended. They differ from each other in terms of the cognitive domains assessed. The research was designed to provide a profile of cognitive functioning in patients with liver cirrhosis, using an assessment that covers a wider range of cognitive functions than the usual screening battery.

Material And Methods: We examined 138 persons, including 88 with liver cirrhosis and 50 healthy volunteers. The Mini Mental State Examination (MMSE) was used for screening and excluding advanced cognitive impairment. Then, to assess cognitive functions in more detail, the following tests were used: Auditory Verbal Learning Test (AVLT), Letter and Semantic Fluency Tests (LF and SF), Trail Making Test (TMT A&B), Digit Symbol Test (DST), Block Design Test (BDT), and Mental Rotation Test (MRT). The MRT task has not been used in MHE diagnosis so far. Finally, 57 patients and 48 controls took part in the entire study.

Results: Patients with liver cirrhosis commit significantly more errors of intrusions in the AVLT during the delayed free recall trial. Results significantly deviating from the norm in at least 2 tests were found only in 7 cirrhosis patients.

Conclusions: The results do not provide any specific profile of cognitive disturbances in MHE, but suggest that cirrhosis patients have a tendency to commit more memory errors, probably due to subtle impairments of executive function.

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References

Ciecko-Michalska I, Binder M, Wyczesany M, Szewczyk J, Senderecka M, Wojcik J . Electrophysiological correlates of attentional processes in patients with liver cirrhosis without minimal or clinically-overt hepatic encephalopathy. J Physiol Pharmacol. 2012; 63(4):339-46. View

Rouleau I, Imbault H, Laframboise M, Bedard M . Pattern of intrusions in verbal recall: comparison of Alzheimer's disease, Parkinson's disease, and frontal lobe dementia. Brain Cogn. 2001; 46(1-2):244-9. DOI: 10.1016/s0278-2626(01)80076-2. View

McCrea M, Cordoba J, Vessey G, Blei A, Randolph C . Neuropsychological characterization and detection of subclinical hepatic encephalopathy. Arch Neurol. 1996; 53(8):758-63. DOI: 10.1001/archneur.1996.00550080076015. View

Wein C, Koch H, Popp B, Oehler G, Schauder P . Minimal hepatic encephalopathy impairs fitness to drive. Hepatology. 2004; 39(3):739-45. DOI: 10.1002/hep.20095. View

Montgomery J, Bajaj J . Advances in the evaluation and management of minimal hepatic encephalopathy. Curr Gastroenterol Rep. 2010; 13(1):26-33. DOI: 10.1007/s11894-010-0150-z. View

Randolph C, Hilsabeck R, Kato A, Kharbanda P, Li Y, Mapelli D . Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines. Liver Int. 2009; 29(5):629-35. DOI: 10.1111/j.1478-3231.2009.02009.x. View

Bajaj J, Hafeezullah M, Hoffmann R, Varma R, Franco J, Binion D . Navigation skill impairment: Another dimension of the driving difficulties in minimal hepatic encephalopathy. Hepatology. 2007; 47(2):596-604. DOI: 10.1002/hep.22032. View

Kimball D, Smith T, Kahana M . The fSAM model of false recall. Psychol Rev. 2007; 114(4):954-93. PMC: 2839460. DOI: 10.1037/0033-295X.114.4.954. View

Dhiman R, Chawla Y . Minimal hepatic encephalopathy: time to recognise and treat. Trop Gastroenterol. 2008; 29(1):6-12. View

10.

Dhiman R, Saraswat V, Sharma B, Sarin S, Chawla Y, Butterworth R . Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for Study of the Liver. J Gastroenterol Hepatol. 2010; 25(6):1029-41. DOI: 10.1111/j.1440-1746.2010.06318.x. View

11.

Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei A . Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002; 35(3):716-21. DOI: 10.1053/jhep.2002.31250. View

12.

Ciecko-Michalska I, Senderecka M, Szewczyk J, Panasiuk A, Slowik A, Wyczesany M . Event-related cerebral potentials for the diagnosis of subclinical hepatic encephalopathy in patients with liver cirrhosis. Adv Med Sci. 2007; 51:273-7. View

13.

Desgranges B, Baron J, Giffard B, Chetelat G, Lalevee C, Viader F . The neural basis of intrusions in free recall and cued recall: a PET study in Alzheimer's disease. Neuroimage. 2002; 17(3):1658-64. DOI: 10.1006/nimg.2002.1289. View

14.

Ciecko-Michalska I, Wojcik J, Wyczesany M, Binder M, Szewczyk J, Senderecka M . Cognitive evoked response potentials in patients with liver cirrhosis without diagnosis of minimal or overt hepatic encephalopathy. A pilot study. J Physiol Pharmacol. 2012; 63(3):271-6. View

15.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

16.

Fridberg D, Brenner A, Lysaker P . Verbal memory intrusions in schizophrenia: associations with self-reflectivity, symptomatology, and neurocognition. Psychiatry Res. 2010; 179(1):6-11. DOI: 10.1016/j.psychres.2010.06.026. View

17.

Romero-Gomez M, Boza F, Garcia-Valdecasas M, Garcia E, Aguilar-Reina J . Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy. Am J Gastroenterol. 2001; 96(9):2718-23. DOI: 10.1111/j.1572-0241.2001.04130.x. View

18.

Liao L, Zhou L, Le H, Yin J, Ma S . Spatial working memory dysfunction in minimal hepatic encephalopathy: an ethology and BOLD-fMRI study. Brain Res. 2012; 1445:62-72. DOI: 10.1016/j.brainres.2012.01.036. View

19.

Dhiman R, Chawla Y . Minimal hepatic encephalopathy. Indian J Gastroenterol. 2009; 28(1):5-16. DOI: 10.1007/s12664-009-0003-6. View

20.

Duarte-Rojo A, Estradas J, Hernandez-Ramos R, Ponce-de-Leon S, Cordoba J, Torre A . Validation of the psychometric hepatic encephalopathy score (PHES) for identifying patients with minimal hepatic encephalopathy. Dig Dis Sci. 2011; 56(10):3014-23. DOI: 10.1007/s10620-011-1684-0. View