Improvement of regional cerebral blood flow after oral intake of branched-chain amino acids in patients with cirrhosis.
OBJECTIVE
To evaluate the effect of oral intake of branched-chain amino acids (BCAA) on brain perfusion in patients with liver cirrhosis.


METHODS
Single photon emission computed tomography scans were performed in 43 patients with cirrhosis and in 15 age-matched healthy subjects. Twenty-nine out of forty-three patients were randomly treated with either BCAA granules or placebo, and single photon emission computed tomography was performed before and after the treatment. We measured the regional cerebral blood flow values using a three-dimensional stereotaxic region of interest template.


RESULTS
Cirrhotic patients had regions of significant hypoperfusion in the bilateral central (right P=0.039, P<0.05; left P=0.006 P<0.01), parietal (right P=0.018, P<0.05; left P=0.009, P<0.01), angular (right P=0.039, P<0.05; left P 0.008, P<0.01), and left pericallosal segments (P=0.038 P<0.05) as compared with healthy subjects. A significant increase in cerebral perfusion was observed 70 min after the oral intake of BCAA in the angular (right P=0.012, P<0.05; left P=0.049, P<0.05), temporal (right P=0.012, P<0.05; left P=0.038, P<0.05), pericallosal segments (right P=0.025, P<0.05; left P=0.049, P<0.05) and left precentral (P=0.044, P<0.05), parietal (P=0.040, P<0.05) and thalamus (P=0.033, P<0.05). No significant change in perfusion was observed in the placebo group.


CONCLUSIONS
Administration of BCAA rapidly improves cerebral perfusion.
Yamamoto
Mika
M
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mie University School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan.
Iwasa
Motoh
M
Matsumura
Kaname
K
Nakagawa
Yuri
Y
Fujita
Naoki
N
Kobayashi
Yoshinao
Y
Kaito
Masahiko
M
Takeda
Kan
K
Adachi
Yukihiko
Y
D000284:Administration, Oral; D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage* / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015609:Organotechnetium Compounds / Q000378:metabolism; D010919:Placebos; D012039:Regional Blood Flow; D015899:Tomography, Emission-Computed, Single-Photon
D000597:Amino Acids, Branched-Chain; D015609:Organotechnetium Compounds; D010919:Placebos