title: Significant volume reduction and shape abnormalities of the basal ganglia in cases of chronic liver cirrhosis.
abstract: OBJECTIVE
  Chronic liver disease frequently includes cognitive and movement disorders, suggesting an alteration of the striatum. With the exception of hyperintensities evident on T1-weighted images indicative of Mn deposition, radiographic findings of the BG are nonspecific. Volumetric and morphometric analysis of DGM is limited. Whether DGM undergoes degeneration and whether this change is associated with pallidal hyperintensity and cognitive performance are currently unknown in patients with cirrhosis.
  
  
  METHODS
  The DGM volumes of 28 patients with chronic cirrhosis and 28 control patients were compared. Using 3D high-resolution MR images, the volume and shape of each structure were automatically analyzed by the FSL. Correlations between the DGM volume and other clinical variables, including the pallidal signal intensity, were assessed by multiple regression analysis.
  
  
  RESULTS
  Patients with Child B and Child C liver disease had significantly smaller bilateral putaminal volumes than control patients, and patients with Child C also demonstrated smaller left caudate nucleus and left amygdala volumes than control patients. Pallidal hyperintensity correlated with smaller striatum volume, which was linearly related to worse cognitive performance. The nonuniform distributed shape abnormalities in the striatum further support the ascending spiral interconnecting theory of the striatum.
  
  
  CONCLUSIONS
  These findings strongly suggest lower DGM volume develops according to the severity of the liver cirrhosis. The Mn deposition might contribute the striatum deficit. These findings support the value of additional psychomotor research associated with liver cirrhosis.
authors.affiliation: Department of Diagnostic Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Lin
authors.forename: K-H
authors.initials: KH
authors.lastname: Chou
authors.forename: C-L
authors.initials: CL
authors.lastname: Chen
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: H-L
authors.initials: HL
authors.lastname: Chen
authors.forename: J A
authors.initials: JA
authors.lastname: Feekes
authors.forename: N-W
authors.initials: NW
authors.lastname: Hsu
authors.forename: S-H
authors.initials: SH
authors.lastname: Li
authors.forename: Y-F
authors.initials: YF
authors.lastname: Cheng
authors.forename: C-P
authors.initials: CP
authors.lastname: Lin
mesh_terms: D001479:Basal Ganglia / Q000473:pathology*; D002908:Chronic Disease; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008103:Liver Cirrhosis / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies
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