title: Resting-state functional connectivity abnormalities correlate with psychometric hepatic encephalopathy score in cirrhosis.
abstract: OBJECTIVE
  Neurocognitive impairment is a common complication of cirrhosis and regarded as the important characteristic for early stage of hepatic encephalopathy (HE). This study aimed to investigate the changes in brain network centrality of functional connectivity among cirrhotic patients and uncover the mechanisms about early HE.
  
  
  METHODS
  Twenty-four cirrhotic patients without overt HE and 21 healthy controls were enrolled and underwent resting-state fMRI and Psychometric Hepatic Encephalopathy Score (PHES) tests. Whole-brain functional network was constructed by measuring the temporal correlations of every pairs of brain gray matter voxels; and then voxel-wise degree centrality (DC), an index reflecting importance of a node in functional integration, was calculated and compared between two groups. A seed-based resting-state functional connectivity (RSFC) analysis was further performed to investigate abnormal functional connectivity pattern of those regions with changed DC.
  
  
  RESULTS
  Compared with controls, the cirrhotic patients had worse performances in all neurocognitive tests and lower PHES score. Meanwhile, patients showed decreased DC in bilateral medial prefrontal gyrus and anterior cingulate cortex, left middle frontal gyrus, and bilateral thalamus; while increased DC in right middle occipital gyrus and parahippocampal gyrus/inferior temporal gyrus. The seed-based RSFC analyses revealed that the relevant functional networks, such as default-mode and attention networks, visual network, and thalamo-cortical circuits, were disturbed in cirrhotic patients. The DC changes were correlated with PHES score in patient group.
  
  
  CONCLUSIONS
  Our findings further confirm brain network disorganization in cirrhotic patients with neurocognitive impairments and may provide a new perspective for understanding HE-related mechanisms.
authors: Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. Electronic address: chj0075@126.com.
authors: Hua-Jun
authors: HJ
authors: Chen
authors: Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors: Long-Feng
authors: LF
authors: Jiang
authors: Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors: Tao
authors: T
authors: Sun
authors: Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors: Jun
authors: J
authors: Liu
authors: School of Information Science and Engineering, Central South University, Changsha 410083, China.
authors: Qiu-Feng
authors: QF
authors: Chen
authors: Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. Electronic address: shihb@vip.sina.com.
authors: Hai-Bin
authors: HB
authors: Shi
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods*; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics; D012146:Rest
keywords: Cirrhosis; Degree centrality; Functional connectivity; Hepatic encephalopathy