title: Anomalous gray matter structural networks in patients with hepatitis B virus-related cirrhosis without overt hepatic encephalopathy.
abstract: OBJECTIVE
  Increasing evidence suggests that cirrhosis may affect the connectivity among different brain regions in patients before overt hepatic encephalopathy (OHE) occurs. However, there has been no study investigating the structural reorganization of these altered connections at the network level. The primary focus of this study was to investigate the abnormal topological organization of the structural network in patients with hepatitis B virus-related cirrhosis (HBV-RC) without OHE using structural MRI.
  
  
  METHODS
  Using graph theoretical analysis, we compared the global and regional topological properties of gray matter structural networks between 28 patients with HBV-RC without OHE and 30 age-, sex- and education-matched healthy controls. The structural correlation networks were constructed for the two groups based on measures of gray matter volume.
  
  
  RESULTS
  The brain network of the HBV-RC group exhibited a significant decrease in the clustering coefficient and reduced small-worldness at the global level across a range of network densities. Regionally, brain areas with altered nodal degree/betweenness centrality were observed predominantly in association cortices (frontal and temporal regions) (p < 0.05, uncorrected), including a significantly decreased nodal degree in the inferior temporal gyrus (p < 0.001, uncorrected). Furthermore, the HBV-RC group exhibited a loss of association hubs and the emergence of an increased number of non-association hubs compared with the healthy controls.
  
  
  CONCLUSIONS
  The results of this large-scale gray matter structural network study suggest reduced topological organization efficiency in patients with HBV-RC without OHE. Our findings provide new insight concerning the mechanisms of neurobiological reorganization in the HBV-RC brain from a network perspective.
authors.affiliation: Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Lv
authors.affiliation: Medical Imaging Centre, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of medical imaging, The First Affiliated Hospital of Gannan Medical University, Ganzhou, People's Republic of China; Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, Guangzhou, People's Republic of China.
authors.forename: Ying-Wei
authors.initials: YW
authors.lastname: Qiu
authors.affiliation: Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Pei-Qiang
authors.initials: PQ
authors.lastname: Cai
authors.affiliation: Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, Guangzhou, People's Republic of China.
authors.forename: Gui-Hua
authors.initials: GH
authors.lastname: Jiang
authors.affiliation: Medical Imaging Centre, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
authors.forename: Yan-Jia
authors.initials: YJ
authors.lastname: Deng
authors.affiliation: Medical Imaging Centre, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
authors.forename: Xue-Lin
authors.initials: XL
authors.lastname: Zhang
authors.affiliation: Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Pei-Hong
authors.initials: PH
authors.lastname: Wu
authors.affiliation: Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Chuan-Miao
authors.initials: CM
authors.lastname: Xie
authors.affiliation: Medical Imaging Centre, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
authors.forename: Ge
authors.initials: G
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006501:Hepatic Encephalopathy / Q000209:etiology; D006509:Hepatitis B / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000473:pathology*