title: Brain metabolism in minimal hepatic encephalopathy assessed by 3.0-Tesla magnetic resonance spectroscopy.
abstract: OBJECTIVE
  To examine whether the brain exhibits metabolic disorder prior to overt hepatic encephalopathy in patients with liver cirrhosis (LC), the intracerebral glutamine and myo-inositol levels were determined using 3.0-Tesla (T)(1) H (proton) magnetic resonance spectroscopy (MRS).
  
  
  METHODS
  We tested 21 LC patients, including seven patients with minimal hepatic encephalopathy (MHE).
  
  
  RESULTS
  No significant differences were noted between the two patient groups in terms of the severity of LC, levels of blood ammonia or levels of blood or liver enzymes. In the MHE group, the levels of brain glutamine were significantly higher than those in the non-MHE group, whereas the levels of brain myo-inositol were significantly lower. This demonstrated that MHE patients were already exhibiting metabolic disorder in the brain, similar to those observed during overt hepatic encephalopathy.
  
  
  CONCLUSIONS
  A quantitative analysis of this phenomenon using MRS may contribute to an early and objective diagnosis of MHE.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kooka
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University.
authors.forename: Kei
authors.initials: K
authors.lastname: Sawara
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University.
authors.forename: Ryujin
authors.initials: R
authors.lastname: Endo
authors.affiliation: Morioka Municipal Hospital.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Kato
authors.affiliation: Department of Nutritional Science, Morioka University, Morioka, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takikawa
keywords: glutamine; magnetic resonance spectroscopy; minimal hepatic encephalopathy; myo-inositol