title: Clinical significance of extrapyramidal signs in patients with cirrhosis.
abstract: OBJECTIVE
  Extrapyramidal signs have been described in cirrhosis and there is little information about their clinical significance. The aims of this study have been to investigate the relationship between extrapyramidal signs and cognitive impairment, and what is their influence on quality of life.
  
  
  METHODS
  46 patients with cirrhosis were evaluated for cognitive impairment with psychometric tests (Trail-Making Test part A, Grooved-Pegboard, Block-Design, Oral Symbol Digit and Stroop Test) and cognitive evoked potentials (P300). Extrapyramidal signs were evaluated using the UPDRS scale. Health-related quality of life (HRQL) was measured using SF-36 scale and the Chronic Liver Disease Questionnaire (CLDQ).
  
  
  RESULTS
  Twenty-two patients had extrapyramidal signs, and these patients scored worse in all psychometric tests, except Block-Design. Patients with extrapyramidal signs also showed a longer P300 latency. Moreover, patients with extrapyramidal signs had the worst score in all the HRQL scales used. A multivariate analysis disclosed that the only variable showing an independent relationship to the mental component summary of SF-36 and with CLDQ was UPDRS score.
  
  
  CONCLUSIONS
  We have found a clear relationship between the presence of extrapyramidal signs and cognitive impairment. Moreover, patients with extrapyramidal signs have worse scores in quality of life scales.
authors.affiliation: Department of Gastroenterology-Liver Unit, Hospital General Universitario de Alicante, C/Pintor Baeza, sn, E-03010 Alicante, Spain. jover_rod@gva.es
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jover
authors.forename: Luís
authors.initials: L
authors.lastname: Compañy
authors.forename: Ana
authors.initials: A
authors.lastname: Gutiérrez
authors.forename: Macarena
authors.initials: M
authors.lastname: Lorente
authors.forename: Pedro
authors.initials: P
authors.lastname: Zapater
authors.forename: María J
authors.initials: MJ
authors.lastname: Poveda
authors.forename: José
authors.initials: J
authors.lastname: Such
authors.forename: Sonia
authors.initials: S
authors.lastname: Pascual
authors.forename: José M
authors.initials: JM
authors.lastname: Palazón
authors.forename: Fernando
authors.initials: F
authors.lastname: Carnicer
authors.forename: Francisco
authors.initials: F
authors.lastname: Ferrandis
authors.forename: Miguel
authors.initials: M
authors.lastname: Pérez-Mateo
mesh_terms: D001480:Basal Ganglia Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D018913:Event-Related Potentials, P300; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life