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Related Concept Videos

Hepatic Encephalopathy01:29

Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
Long-term Depression01:05

Long-term Depression

Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Long-term Depression01:03

Long-term Depression

Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over time, all...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Encephalitis ll: Pathophysiology01:26

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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...

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Simultaneous Electroencephalography, Real-time Measurement of Lactate Concentration and Optogenetic Manipulation of Neuronal Activity in the Rodent Cerebral Cortex
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Published on: December 19, 2012

Increase brain lactate in hepatic encephalopathy: cause or consequence?

Christopher F Rose1

  • 1Neuroscience Research Unit, CRCHUM, Hôpital Saint-Luc, Université de Montréal, Montréal, Québec, Canada. christopher.rose@umontreal.ca

Neurochemistry International
|July 6, 2010
PubMed
Summary

Hepatic encephalopathy (HE) involves increased brain lactate. This review examines why brain lactate rises in liver failure and its role in HE pathogenesis.

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Simultaneous Electroencephalography, Real-time Measurement of Lactate Concentration and Optogenetic Manipulation of Neuronal Activity in the Rodent Cerebral Cortex
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Published on: November 20, 2015

Area of Science:

  • Neuroscience
  • Hepatology
  • Biochemistry

Background:

  • Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome linked to liver failure.
  • Elevated brain lactate levels are frequently observed in patients with HE.
  • The precise relationship between brain lactate and HE pathogenesis is not fully understood.

Purpose of the Study:

  • To explore the various reasons for lactate accumulation in the brain during liver failure.
  • To elucidate the potential roles of lactate in the development of HE.

Main Methods:

  • Review of existing literature on lactate metabolism in the brain during liver disease.
  • Analysis of proposed mechanisms for cerebral lactate increase, including blood-brain barrier transport, altered glycolysis, and metabolic shifts.
  • Synthesis of evidence regarding lactate's contribution to HE symptoms.

Main Results:

  • Cerebral lactate can increase due to hyperlactataemia crossing the blood-brain barrier.
  • Impaired brain energy metabolism and increased glycolysis contribute to lactate buildup.
  • Altered lactate production/utilization pathways in the brain are implicated.

Conclusions:

  • Lactate accumulation in the brain is a significant feature of hepatic encephalopathy.
  • Understanding the mechanisms of cerebral lactate increase is crucial for HE treatment.
  • Further research is needed to definitively establish lactate's causal role in HE pathogenesis.