Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy

M. Albert Thomas, Amir Huda, Barry Guze, John Curran, Mary Bugbee, Lynn Fairbanks, Yong Ke, Thomas Oshiro, Paul Martin, Fawzy Fawzy

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

OBJECTIVE. Our objective was to assess the metabolite levels (myo- inositol [mI], choline [Cho], creatine [Cr], glutamate or glutamine [Glx], and N-acetyl-L-aspartate [NAA]) visible on 1H MR spectroscopy in patients with subclinical and mild hepatic encephalopathy before and after liver transplantation and to correlate these data with the results of neuropsychiatric tests and related clinical findings. SUBJECTS AND METHODS. A stimulated-echo sequence was used to localize a single voxel in the parietal region. Seventeen patients and 13 healthy volunteers were investigated. Nine of the 17 patients also were investigated after liver transplantation. A battery of neuropsychologic tests also was administered to patients to assess frontal, memory, and motor functions. RESULTS. Before liver transplantation, significant reductions in mI:Cr (51%) and Cho:Cr (11%) and a significant increase in Glx:Cr (20%) were observed in patients compared with the respective ratios in healthy subjects. Patients also were significantly impaired on neuropsychologic tests measuring frontal and motor performance, but not memory. Impairment on the frontal index showed a significant correlation with mI:Cr levels; likewise, performance on the motor index showed a significant correlation with serum ammonia levels before transplantation. MR spectroscopy after liver transplantation showed changes in the metabolite ratios compared with the pretransplantation status. Even though the Glx:Cr ratios decreased after transplantation, the mI:Cr ratio remained lower than those of healthy subjects. CONCLUSION. The relationship of changes in the metabolite ratios recorded from a voxel in the posteromedial parietal lobe to the neuropsychologic findings before and after liver transplantation is a major finding.

Original languageEnglish
Pages (from-to)1123-1130
Number of pages8
JournalAmerican Journal of Roentgenology
Volume171
Issue number4
StatePublished - Oct 1 1998
Externally publishedYes

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Hepatic Encephalopathy
Creatine
Magnetic Resonance Spectroscopy
Liver Transplantation
Inositol
Healthy Volunteers
Parietal Lobe
Neuropsychological Tests
Choline
Transplantation
Glutamine
Ammonia
Glutamic Acid
Serum

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Albert Thomas, M., Huda, A., Guze, B., Curran, J., Bugbee, M., Fairbanks, L., ... Fawzy, F. (1998). Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy. American Journal of Roentgenology, 171(4), 1123-1130.

Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy. / Albert Thomas, M.; Huda, Amir; Guze, Barry; Curran, John; Bugbee, Mary; Fairbanks, Lynn; Ke, Yong; Oshiro, Thomas; Martin, Paul; Fawzy, Fawzy.

In: American Journal of Roentgenology, Vol. 171, No. 4, 01.10.1998, p. 1123-1130.

Research output: Contribution to journalArticle

Albert Thomas, M, Huda, A, Guze, B, Curran, J, Bugbee, M, Fairbanks, L, Ke, Y, Oshiro, T, Martin, P & Fawzy, F 1998, 'Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy', American Journal of Roentgenology, vol. 171, no. 4, pp. 1123-1130.
Albert Thomas M, Huda A, Guze B, Curran J, Bugbee M, Fairbanks L et al. Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy. American Journal of Roentgenology. 1998 Oct 1;171(4):1123-1130.
Albert Thomas, M. ; Huda, Amir ; Guze, Barry ; Curran, John ; Bugbee, Mary ; Fairbanks, Lynn ; Ke, Yong ; Oshiro, Thomas ; Martin, Paul ; Fawzy, Fawzy. / Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy. In: American Journal of Roentgenology. 1998 ; Vol. 171, No. 4. pp. 1123-1130.
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abstract = "OBJECTIVE. Our objective was to assess the metabolite levels (myo- inositol [mI], choline [Cho], creatine [Cr], glutamate or glutamine [Glx], and N-acetyl-L-aspartate [NAA]) visible on 1H MR spectroscopy in patients with subclinical and mild hepatic encephalopathy before and after liver transplantation and to correlate these data with the results of neuropsychiatric tests and related clinical findings. SUBJECTS AND METHODS. A stimulated-echo sequence was used to localize a single voxel in the parietal region. Seventeen patients and 13 healthy volunteers were investigated. Nine of the 17 patients also were investigated after liver transplantation. A battery of neuropsychologic tests also was administered to patients to assess frontal, memory, and motor functions. RESULTS. Before liver transplantation, significant reductions in mI:Cr (51{\%}) and Cho:Cr (11{\%}) and a significant increase in Glx:Cr (20{\%}) were observed in patients compared with the respective ratios in healthy subjects. Patients also were significantly impaired on neuropsychologic tests measuring frontal and motor performance, but not memory. Impairment on the frontal index showed a significant correlation with mI:Cr levels; likewise, performance on the motor index showed a significant correlation with serum ammonia levels before transplantation. MR spectroscopy after liver transplantation showed changes in the metabolite ratios compared with the pretransplantation status. Even though the Glx:Cr ratios decreased after transplantation, the mI:Cr ratio remained lower than those of healthy subjects. CONCLUSION. The relationship of changes in the metabolite ratios recorded from a voxel in the posteromedial parietal lobe to the neuropsychologic findings before and after liver transplantation is a major finding.",
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AU - Oshiro, Thomas

AU - Martin, Paul

AU - Fawzy, Fawzy

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