Grey and white matter abnormalities in minimal hepatic encephalopathy: a study combining voxel-based morphometry and...

Area of Science:

• Neurology
• Radiology
• Hepatology

Background:

• Low-grade cerebral edema is a hallmark of minimal hepatic encephalopathy (MHE) in cirrhosis.
• Investigating brain changes in MHE is crucial for understanding disease progression.

Purpose of the Study:

• To investigate grey matter (GM) and white matter (WM) changes in MHE patients.
• To combine voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) for comprehensive analysis.

Main Methods:

• 25 MHE patients and 25 healthy controls underwent 3D T1 and diffusion-tensor imaging.
• VBM assessed regional GM volume differences.
• TBSS analyzed WM fractional anisotropy (FA) and mean diffusivity (MD) differences.

Main Results:

• VBM showed decreased GM volume in frontal/temporal cortices, caudate, putamen, amygdala, and increased GM in the thalamus.
• TBSS revealed decreased FA in WM areas including the corpus callosum and corticospinal tract.
• Increased MD in MHE patients was extensive, affecting numerous WM tracts.

Conclusions:

• Cortical atrophy and low-grade white matter edema coexist in minimal hepatic encephalopathy.
• Combined VBM and TBSS provide detailed insights into brain alterations in MHE.