The influence of HE history, HE status and neuropsychological test type on learning ability in patients with cirrhosis

Autores de CIPF

• Carmina Montoliu Felix

  Autor

• 

  Vicente Felipo Orts

  Autor

Participantes ajenos a CIPF

• Zarantonello L
• Turco M
• Formentin C
• Izquierdo-Altarejos P
• Vuerich A
• Barcenas Jimenez MJ
• Angeli P
• Amodio P
• Montagnese S

Grupos de Investigación

• Laboratorio de Neurobiología

  

  Jefe/a de Grupo

  Vicente Felipo Orts

• Unidad Mixta CIPF-INCLIVA de Deterioro Neurológico

Abstract

Background & Aims Learning ability may be impaired in patients with a history of overt hepatic encephalopathy (OHE). The aim of this study was to compare performance on the first/second attempt at a series of tests. Methods Two hundred and fourteen patients with cirrhosis were enrolled. On the day of study, 41% were classed as unimpaired, 38% as having minimal HE and 21% as having mild OHE; 58% had a history of OHE. Performance was compared between two versions of the trail-making test A (TMT-A), and between the first/second half of a simple/choice reaction time (sRT and cRT), and a working memory test (ScanRT). Results Both patients with and without OHE history improved in TMT-A, sRT and ScanRT. Only patients with no OHE history improved in cRT. All patients, regardless of their HE status on the day of study, improved in TMT-A and sRT. Only patients with mild OHE on the day of study improved in cRT. Only unimpaired patients improved in ScanRT. When OHE history and HE status on the day of study were tested together, only HE status had an effect. The same held true when age, the Model for End Stage Liver Disease (MELD) and educational attainment were adjusted for. Conclusions HE status on the day of study and the type of neuropsychological test had an effect on learning ability in a well-characterized group of patients with cirrhosis.

Keywords

• cirrhosis; hepatic encephalopathy; learning ability; neuropsychological test