title: Chemical shift magnetic resonance spectroscopy of cingulate grey matter in patients with minimal hepatic encephalopathy.
abstract: Minimal hepatic encephalopathy (MHE) is frequently diagnosed in patients with liver cirrhosis who do not show overt clinical cirrhosis-associated neurological deficits. This condition manifests primarily with visuo-motor and attention deficits. We studied the association between visuo-motor deficits and magnetic resonance spectroscopic parameters in cingulate grey matter and white matter of centrum semiovale in patients with liver cirrhosis. The data revealed an increase in the glutamate-glutamine/creatine ratio and a decrease in choline/creatine and inositol/creatine ratios in patients with liver cirrhosis. The analysis of the data showed that cirrhosis-associated deterioration of the visuo-motor function significantly correlates with a decrease in the choline/creatine ratio and an increase in N-acetylaspartate/choline in cingulate grey matter but not in the neighbouring white matter. Furthermore, the increase in the glutamate-glutamine/creatine ratio correlated significantly with the increase in the N-acetylaspartate/creatine ratio. These data suggest an association between altered choline, glutamate-glutamine and NAA metabolism in cingulate grey matter and symptoms of MHE, and underline the importance of differentiation between grey and white matter in magnetic resonance spectroscopic studies on patients with cirrhosis-associated brain dysfunction.
authors.affiliation: Department of General Psychiatry, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. s.mechtcheriakov@uibk.ac.at
authors.forename: Sergei
authors.initials: S
authors.lastname: Mechtcheriakov
authors.forename: Michael
authors.initials: M
authors.lastname: Schocke
authors.forename: André
authors.initials: A
authors.lastname: Kugener
authors.forename: Ivo W
authors.initials: IW
authors.lastname: Graziadei
authors.forename: Michael
authors.initials: M
authors.lastname: Mattedi
authors.forename: Hartmann
authors.initials: H
authors.lastname: Hinterhuber
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
authors.forename: Josef
authors.initials: J
authors.lastname: Marksteiner
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D002540:Cerebral Cortex / Q000378:metabolism; D002794:Choline / Q000032:analysis; D003404:Creatinine / Q000032:analysis; D005260:Female; D018698:Glutamic Acid / Q000032:analysis; D005973:Glutamine / Q000032:analysis; D006179:Gyrus Cinguli / Q000378:metabolism*; D006501:Hepatic Encephalopathy / Q000378:metabolism*; D006801:Humans; D007294:Inositol / Q000032:analysis; D007361:Intelligence Tests; D008103:Liver Cirrhosis / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008568:Memory / Q000502:physiology; D008570:Memory, Short-Term / Q000502:physiology; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D014145:Trail Making Test
chemical_list: D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003404:Creatinine; D002794:Choline