title: Differences in cognitive function between patients with viral and alcoholic compensated liver cirrhosis.
abstract: As alcohol induces change in frontal cortex primarily involved in cognition, cognitive function may be different between viral and alcoholic liver cirrhosis (LC). This study aimed to determine the differences of cognitive function between viral and alcoholic compensated LC. From October 2011 to March 2013, 80 patients (viral: 37; alcohol: 43) with compensated LC were prospectively enrolled. Neuropsychological functions including attention, language, visuospatial, verbal memory, visual memory, and frontal/executive function were evaluated between two groups and compared with age-matched normal group (n = 1000). Cumulative incidence rate of overt hepatic encephalopathy (HE) was calculated. In the comparison with normal group, both two groups showed decreased memory function, frontal/executive function, and Korea-Mini Mental Status Examination. In the analysis of two groups, memory function by Verbal Learning Test (recognition: 20.1 ± 3.6 and 17.8 ± 4.8, p = 0.022), visuospatial function by Ray-Complex Figure Copy Test (recognition: 19.0 ± 2.6 and 17.3 ± 4.0, p = 0.043), frontal/executive function by Controlled Oral Ward Association (semantic: 17.1 ± 6.9 and 12.7 ± 6.9, p = 0.004), and the Korea-Mini Mental Status Examination (27.5 ± 1.9 and 26.2 ± 3.1, p = 0.03) showed low scores in alcoholic compensated LC patients. The 1-, 2-, and 3-year cumulative incidence rates of overt HE were 23%, 26%, and 26% and 33%, 43%, and 49% in the viral and alcoholic compensated LC group, respectively (p = 0.033). Impaired memory and frontal lobe executive functions and early development of overt HE were more common in patients with alcoholic LC. For patients with alcoholic LC, more integrated tests for early detection of minimal HE and intensive treatment should be considered to prevent overt HE.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Yunhyeong
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Neurology, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Chulho
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.|Department of Medicine, Columbia University, New York, NY, USA.|Department in Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon,, Gyo-dong, 200-704, South Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.affiliation: Department of Neurology, Hallym University College of Medicine, Chuncheon, South Korea. dohchi@hallym.or.kr.|Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Gyo-dong, 200-704, South Korea. dohchi@hallym.or.kr.
authors.forename: Hui Chul
authors.initials: HC
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Chang Seok
authors.initials: CS
authors.lastname: Bang
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Jai Hoon
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Min Uk
authors.initials: MU
authors.lastname: Jang
authors.affiliation: Department of Neurology, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000503:physiopathology* / Q000821:virology; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: Alcohol; Cognition; Hepatic encephalopathy; Liver cirrhosis