FYI...Evidence of Persistent Cognitive Impairment After Resolution of Overt Hepatic Encephalopathy

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http://www.cghjournal.org/article/PIIS1542356510009778/abstract?rss=yes

Clinical Gastroenterology and Hepatology

Volume 9, Issue 2 , Pages 181-183, February 2011

Evidence of Persistent Cognitive Impairment After Resolution of Overt Hepatic

Encephalopathy

Oliviero Riggio

Affiliations

Reprint requests Address requests for reprints to: Prof. Oliviero Riggio, MD,

Associate Professor of Gastroenterology, II Gastroenterologia, Dipartimento di

Medicina Clinica, “Sapienza” Universtà di Roma, Viale dell'Università 37, 00185

Roma, Italy. fax: 39-06-49972001

Lorenzo Ridola, Chiara Pasquale, Silvia Nardelli, Ilaria Pentassuglio, Federica

Moscucci, a Merli

published online 18 October 2010.

Abstract

Background & Aims

The Inhibitory Control Test has been proposed as a tool to detect the

persistence of cognitive defects after the resolution of overt hepatic

encephalopathy (OHE). We tested learning abilities of cirrhotic patients using

the Psychometric Hepatic Encephalopathy Score (PHES).

Methods

One hundred six cirrhotic patients who agreed to be examined twice within 3 days

were studied using the PHES. Twenty-seven patients had previous OHE; of the

remaining 79 patients, 34 were affected by minimal HE and 45 were normal.

Results

Among patients without previous OHE, PHESs significantly improved at the second

examination; this learning effect was present in the patients with or without

minimal HE. To the contrary, learning ability was lost in patients with previous

OHE. Even among the 8 patients with history of HE and normal PHESs in the first

examination, repeated testing showed a lack of learning capacity.

Conclusions

HE is not a fully reversible condition. Residual cognitive impairments should be

evaluated by specific tests, based on patients' learning capacities.

Conflicts of interest The authors disclose no conflicts.

Funding Lorenzo Ridola was supported by the 2010 “Young Investigator Award”

given by the Italian Society of Gastroenterology (SIGE).

PII: S1542-3565(10)00977-8

doi:10.1016/j.cgh.2010.10.002

© 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.