title: Neural mechanism of cognitive control impairment in patients with hepatic cirrhosis: a functional magnetic resonance imaging study.
abstract: BACKGROUND
  Many studies have claimed the existence of attention alterations in cirrhotic patients without overt hepatic encephalopathy (HE). No functional magnetic resonance imaging (fMRI) study in this respect has been published.
  
  
  OBJECTIVE
  To investigate the neural basis of cognitive control deficiency in cirrhotic patients using fMRI.
  
  
  METHODS
  14 patients with hepatic cirrhosis and 14 healthy volunteers were included in the study. A modified Stroop task with Chinese characters was used as the target stimulus, and block-design fMRI was used to acquire resource data, including four stimulus blocks and five control blocks, each presented alternatively. Image analysis was performed using statistical parametric mapping 99. After fMRI examinations were complete, behavior tests of Stroop interference were performed for all subjects. Overall reaction time and error numbers were recorded.
  
  
  RESULTS
  Both healthy volunteers and patients with hepatic cirrhosis had Stroop interference effects. Patients with hepatic cirrhosis had more errors and longer reaction time in performing an incongruous color-naming task than healthy volunteers (P<0.001); there was no significant difference in performing an incongruous word-reading task (P = 0.066). Compared with controls, patients with hepatic cirrhosis had greater activation of the bilateral prefrontal cortex and parietal cortex when performing the incongruous word-reading task. With increased conflict, activation of the anterior cingulate cortex (ACC), bilateral prefrontal cortex (PFC), parietal lobe, and temporal fusiform gyrus (TFG) was decreased when patients with hepatic cirrhosis performed the incongruous color-naming task.
  
  
  CONCLUSIONS
  This study demonstrates that patients with hepatic cirrhostic have cognitive control deficiency. The abnormal brain network of the ACC-PFC-parietal lobe-TFG is the neural basis of cognitive control impairment in cirrhotic patients.
authors.affiliation: Department of Radiology, Tianjin First Central Hospital of Tianjin Medical University, Tianjin, PR China. kevinzhanglongjiang@yahoo.com.cn
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
authors.forename: Guifen
authors.initials: G
authors.lastname: Yang
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Yin
authors.forename: Yawu
authors.initials: Y
authors.lastname: Liu
authors.forename: Ji
authors.initials: J
authors.lastname: Qi
mesh_terms: D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011932:Reading