Breakfast improves cognitive function in cirrhotic patients with cognitive impairment

Area of Science:

• Neuroscience
• Hepatology
• Nutritional Science

Background:

• Cognitive disturbances are common in liver disease patients.
• Minimal hepatic encephalopathy (MHE) is a frequent neurocognitive complication in cirrhosis.
• High protein intake can precipitate hepatic encephalopathy.

Purpose of the Study:

• To investigate the impact of acute metabolic changes from breakfast consumption on cognition in cirrhosis patients.
• To explore the influence of nutritional factors on cognitive impairment progression in MHE.

Main Methods:

• 21 Child A cirrhosis patients and 21 healthy controls were enrolled.
• Participants were divided into groups receiving breakfast (500 kcal, 21g protein) or fasting.
• Serum ammonia and cognitive functions (Mindstreams; NeuroTrax) were assessed pre- and post-breakfast.

Main Results:

• Cirrhotic patients exhibited significantly lower cognitive scores, indicative of MHE.
• Hyperammonemia correlated with lower attention scores in patients.
• Breakfast consumption improved attention and executive functions in MHE patients, contrasting with controls.

Conclusions:

• Chronic hyperammonemia negatively impacts attention in cirrhosis.
• Breakfast intake enhances cognitive functions (attention, executive function) in MHE patients.
• Periods of prolonged fasting may contribute to cognitive decline in liver disease.