title: Altered regional homogeneity in the development of minimal hepatic encephalopathy: a resting-state functional MRI study.
abstract: BACKGROUND
  Little is known about how spontaneous brain activity progresses from non-hepatic encephalopathy (non-HE) to minimal HE (MHE). The purpose of this study was to evaluate the evolution pattern of spontaneous brain activities in cirrhotic patients using resting-state fMRI with a regional homogeneity (ReHo) method.
  
  
  RESULTS
  Resting-state fMRI data were acquired in 47 cirrhotic patients (minimal HE [MHE], n = 20, and non-HE, n = 27) and 25 age-and sex-matched healthy controls. The Kendall's coefficient of concordance (KCC) was used to measure the regional homogeneity. The regional homogeneity maps were compared with ANOVA tests among MHE, non-HE, and healthy control groups and t-tests between each pair in a voxel-wise way. Correlation analyses were performed to explore the relationships between regional ReHo values and Child-Pugh scores, number connection test type A (NCT-A), digit symbol test (DST) scores, venous blood ammonia levels. Compared with healthy controls, both MHE and non-HE patients showed decreased ReHo in the bilateral frontal, parietal and temporal lobes and increased ReHo in the bilateral caudate. Compared with the non-HE, MHE patients showed decreased ReHo in the bilateral precuneus, cuneus and supplementary motor area (SMA). The NCT-A of cirrhotic patients negatively correlated with ReHo values in the precuneus, cuneus and lingual gyrus. DST scores positively correlated with ReHo values in the cuneus, precuneus and lingual gyrus, and negatively correlated with ReHo values in the bilateral caudate (P<0.05, AlphaSim corrected).
  
  
  CONCLUSIONS
  Diffused abnormal homogeneity of baseline brain activity was nonspecific for MHE, and only the progressively decreased ReHo in the SMA and the cuneus, especially for the latter, might be associated with the development of MHE. The ReHo analysis may be potentially valuable for detecting the development from non-HE to MHE.
authors: Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, China.
authors: Ling
authors: L
authors: Ni
authors: Rongfeng
authors: R
authors: Qi
authors: Long Jiang
authors: LJ
authors: Zhang
authors: Jianhui
authors: J
authors: Zhong
authors: Gang
authors: G
authors: Zheng
authors: Zhiqiang
authors: Z
authors: Zhang
authors: Yuan
authors: Y
authors: Zhong
authors: Qiang
authors: Q
authors: Xu
authors: Wei
authors: W
authors: Liao
authors: Qing
authors: Q
authors: Jiao
authors: Xingjiang
authors: X
authors: Wu
authors: Xinxin
authors: X
authors: Fan
authors: Guang Ming
authors: GM
authors: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001481:Basal Metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006501:Hepatic Encephalopathy / Q000378:metabolism* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged