title: Incomplete improvement of visuo-motor deficits in patients with minimal hepatic encephalopathy after liver transplantation.
abstract: Previous studies have suggested reversibility of minimal hepatic encephalopathy in patients with liver cirrhosis after liver transplantation (LT), however, this topic is controversially discussed. We investigated this issue in a prospective study on liver cirrhotic patients listed for LT. Patients were investigated before and after liver transplantation (on average 21 months later) using a neuropsychological test battery which measured visuo-constructive and visuo-motor ability, verbal fluency, and memory function. To assess visuo-motor and visuo-constructive functions, we performed 4 tests: Rey Complex Figure Test copy, trail making tests A and B, and digital symbol test. The average percentile score of the tests, arbitrarily named the visuo-motor and visuo-constructive performance score (VMCP), was calculated. After LT, the patients did not demonstrate a significant increase of VMCP (P =.29) and additionally showed significantly lower VMCP score (P =.041) compared to control group. Analysis of individual responses showed that only 7 of 14 patients improved their VMCP values after LT. These data indicate that the cirrhosis-associated visuo-motor deficits subside or disappear only in some of the patients after LT, whereas a significant number of patients show no improvement of the visuo-motor and visuo-constructive function. We concluded that monitoring of cognitive and visuo-motor functioning is important for the post-transplant rehabilitation of patients with liver cirrhosis.
authors.affiliation: Department of General Psychiatry, University of Innsbruck, Innsbruck, Austria. s.mechtcheriakov@uibk.ac.at
authors.forename: Sergei
authors.initials: S
authors.lastname: Mechtcheriakov
authors.forename: Ivo W
authors.initials: IW
authors.lastname: Graziadei
authors.forename: Michael
authors.initials: M
authors.lastname: Mattedi
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodner
authors.forename: André
authors.initials: A
authors.lastname: Kugener
authors.forename: Hartmann H
authors.initials: HH
authors.lastname: Hinterhuber
authors.forename: Josef
authors.initials: J
authors.lastname: Marksteiner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
mesh_terms: D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006501:Hepatic Encephalopathy / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000502:physiology; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009048:Motor Skills; D009483:Neuropsychological Tests; D011184:Postoperative Period; D011446:Prospective Studies; D013060:Speech; D013997:Time Factors; D014785:Vision, Ocular