Psychoneurological symptoms during interferon therapy in patients with chronic hepatitis: prospective study on predictive use of Cornell Medical Index and electroencephalogram.
OBJECTIVE
We assessed the usefulness of the Cornell Medical Index (CMI) and electroencephalogram (EEG) in the prediction and early detection of psychoneurological symptoms associated with interferon (IFN) therapy for chronic viral hepatitis.


METHODS
Forty-eight consecutive patients received IFN for chronic viral hepatitis for 8-24 weeks. CMI was measured before IFN therapy. Serial EEGs were recorded before IFN therapy, 2, 4 weeks, and thereafter every 4 weeks in the therapy.


RESULTS
Psychoneurological symptoms including insomnia, depression, and restlessness were seen in 11 (23%) of 48 patients. Five (13%) of 40 patients with CMI I and II and six (75%) of eight with CMI III developed psychoneurological symptoms (P<0.001). Sensitivity, specificity, and predictive accuracy of CMI III were 55%, 95%, and 75%, respectively. Abnormal EEG such as slow basic rhythm, appeared in 13 patients (27%) during IFN therapy. Psychoneurological symptoms were seen in six (46%) of the 13 patients with abnormal EEG, and in five (14%) of 35 in whom EEG remained normal (P<0.05).


CONCLUSIONS
CMI is useful for the prediction of IFN-induced psychoneurological symptoms in patients with chronic viral hepatitis. Serial EEGs contribute to the screening and auxiliarily assessing the adverse effects of IFN on the central nervous system.
First Department of Internal Medicine, Gifu University School of Medicine, Gifu 500-8513, Japan.
Yuji
Y
Tanaka
Masahito
M
Nagaki
Eiichi
E
Tomita
Masahiko
M
Murase
Masamichi
M
Enya
Yohichi
Y
Nishigaki
Jun'ichi
J
Sugihara
Hisataka
H
Moriwaki
D000328:Adult; D000368:Aged; D003321:Cornell Medical Index; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007372:Interferons / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000139:chemically induced / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D007372:Interferons