title: Impaired evoked and resting-state brain oscillations in patients with liver cirrhosis as revealed by magnetoencephalography.
abstract: A number of studies suggest that the clinical manifestation of neurological deficits in hepatic encephalopathy results from pathologically synchronized neuronal oscillations and altered oscillatory coupling. In the present study spontaneous and evoked oscillatory brain activities were analyzed jointly with established behavioral measures of altered visual oscillatory processing. Critical flicker and fusion frequencies (CFF, FUF) were measured in 25 patients diagnosed with liver cirrhosis and 30 healthy controls. Magnetoencephalography (MEG) data were collected at rest and during a visual task employing repetitive stimulation. Resting MEG and evoked fields were analyzed. CFF and FUF were found to be reduced in patients, providing behavioral evidence for deficits in visual oscillatory processing. These alterations were found to be related to resting brain activity in patients, namely that the lower the dominant MEG frequency at rest, the lower the CFF and FUF. An analysis of evoked fields at sensor level indicated that in comparison to normal controls, patients were not able to dynamically adapt to flickering visual stimulation. Evoked activity was also analyzed based on independent components (ICs) derived by independent component analysis. The similarity between the shape of each IC and an artificial sine function representing the stimulation frequency was tested via magnitude squared coherence. In controls, we observed a small number of components that correlated strongly with the sine function and a high number of ICs that did not correlate with the sine function. Interestingly, patient data were characterized by a high number of moderately correlating components. Taken together, these results indicate a fundamental divergence of the cerebral resonance activity in cirrhotic patients.
authors.affiliation: Biomagnetic Center, Department of Neurology, University Hospital Jena, Erlanger Allee 101, 07747 Jena, Germany ; CSCC, Center for Sepsis Control and Care, Erlanger 101, 07747 Jena, Germany.
authors.forename: Theresa
authors.initials: T
authors.lastname: Götz
authors.forename: Ralph
authors.initials: R
authors.lastname: Huonker
authors.forename: Cornelia
authors.initials: C
authors.lastname: Kranczioch
authors.forename: Philipp
authors.initials: P
authors.lastname: Reuken
authors.forename: Otto W
authors.initials: OW
authors.lastname: Witte
authors.forename: Albrecht
authors.initials: A
authors.lastname: Günther
authors.forename: Stefan
authors.initials: S
authors.lastname: Debener
keywords: CFF, critical flicker frequency; CON, control; CSI, component similarity index; Critical flicker and fusion frequency; EEG, electroencephalography; EMG, electromyogram; ERA, event related averages; FUF, fusion frequency; GSI, general similarity index; GW, Gabor wavelet; HE, hepatic encephalopathy; HESA, hepatic encephalopathy scoring algorithm; ICA, independent component analysis; Impaired neuronal oscillations; Liver cirrhosis; MEG, magnetoencephalography; MELD score, model of end-stage liver disease-score; MSC, magnitude squared coherence; PCA, principal component analysis; Resting frequency; SSVEF/SSVEP/SSVER, steady state visual evoked field/potential/response; SW, sine wave; Visual steady state evoked fields