Event-related cerebral potentials for the diagnosis of subclinical hepatic encephalopathy in patients with liver cirrhosis.
OBJECTIVE
Subclinical hepatic encephalopathy (SHE) seems to be a common problem in liver cirrhosis, however, studies assessing the pathogenesis of this disease remain unclear. Currently no gold standard exists for the diagnosis of this complex neuropsychiatric syndrome. The present study was undertaken firstly to examine the diagnostic usefulness of auditory event-related cerebral potentials (ERPs) in the detection of SHE, and secondly to compare it with that of the most validated psychometric test.


METHODS
22 patients with liver cirrhosis without overt hepatic encephalopathy and 28 healthy controls were studied, using auditory ERPs. In addition they underwent a battery of neuropsychological and laboratory tests.


RESULTS
P300 latency analysis turned out that cirrhotics patients had significantly longer P300 latency than controls. The only neuropsychological test showing significant difference between clinical and control group was the similarities subtest of WAIS-R.


CONCLUSIONS
The results of the present study suggest that ERPs are more sensitive method than psychometric tests in detecting early changes in the brain function of patients with cirrhosis and for this reason this neurophysiological method should be applied in clinical practice.
Ciećko-Michalska
I
I
Department of Gastroenterology, Hepatology and Infectiosus Diseases, Jagiellonian University, Kraków, Poland. michalska@su.krakow.pl
Senderecka
M
M
Szewczyk
J
J
Panasiuk
A
A
Słowik
A
A
Wyczesany
M
M
Binder
M
M
Mach
T
T
D000328:Adult; D002540:Cerebral Cortex / Q000503:physiopathology*; D004569:Electroencephalography; D018913:Event-Related Potentials, P300; D005071:Evoked Potentials; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity