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Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function

Fecha de publicación:

Autores de CIPF

Participantes ajenos a CIPF

  • Rega, D
  • Aiko, M
  • Penaranda, N
  • Gallego, JJ
  • Casanova, F
  • Fiorillo, A
  • San-Miguel, T
  • Ipiens, C
  • Escudero-Garcia, D
  • Tosca, J
  • Monton, C
  • Ballester, MP
  • Ballester, J
  • Aparicio, L
  • Rios, MP
  • Durban, L
  • Mir, A
  • Kosenko, E
  • Cases, P

Grupos de Investigación

Abstract

Cirrhotic patients may experience alterations in the peripheral nervous system and in somatosensory perception. Impairment of the somatosensory system could contribute to cognitive and motor alterations characteristic of minimal hepatic encephalopathy (MHE), which affects up to 40% of cirrhotic patients. We assessed the relationship between MHE and alterations in thermal, vibration, and/or heat pain sensitivity in 58 cirrhotic patients (38 without and 20 with MHE according to Psychometric Hepatic Encephalopathy Score) and 39 controls. All participants underwent attention and coordination tests, a nerve conduction study, autonomic function testing, and evaluation of sensory thresholds (vibration, cooling, and heat pain detection) by electromyography and quantitative sensory testing. The detection thresholds for cold and heat pain on the foot were higher in patients with, than those without MHE. This hyposensitivity was correlated with attention deficits. Reaction times in the foot were longer in patients with, than without MHE. Patients with normal sural nerve amplitude showed altered thermal sensitivity and autonomic function, with stronger alterations in patients with, than in those without MHE. MHE patients show a general decrease in cognitive and sensory abilities. Small fibers of the autonomic nervous system and thermal sensitivity are altered early on in MHE, before large sensory fibers. Quantitative sensory testing could be used as a marker of MHE.

Datos de la publicación

ISSN/ISSNe:
2077-0383, 2077-0383

Journal of Clinical Medicine  MDPI AG

Tipo:
Article
Páginas:
-
PubMed:
33440769

Citas Recibidas en Web of Science: 7

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Keywords

  • minimal hepatic encephalopathy; nerve conduction; thermal sensitivity; autonomic testing

Proyectos asociados

Bases moleculares de las alteraciones neurológicas (cognitivas y motoras) en hiperamonemia y encefalopatía hepática. Implicaciones terapéuticas

Investigador Principal: VICENTE FELIPO ORTS

MINISTERIO DE ECON. Y COMPET. . 2018

Mecanismos moleculares y cerebrales de las alteraciones cognitivas y motoras en hiperamonemia y encefalopatía hepática. Implicaciones terapeúticas y diagnósticas

Investigador Principal: VICENTE FELIPO ORTS

CONSELLERIA DE EDUCACION . 2018

Identification and modelling of molecular and cellular events of the inmune response associated to the appearence of minimal hepatic encephalopaty in cirrhotic patients

Investigador Principal: VICENTE FELIPO ORTS

FUNDACION RAMON ARECES . 2019

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