Hepatic Encephalopathy Is Associated with Persistent Learning Impairments Despite Adequate Medical Treatment: A...

Area of Science:

• Hepatology
• Neuroscience
• Psychology

Background:

• Hepatic encephalopathy (HE) is often considered reversible in terms of mental status.
• However, single-center studies suggest persistent cognitive deficits may occur after HE.
• This study investigates long-term cognitive function in patients with a history of HE.

Purpose of the Study:

• To evaluate the persistence of learning impairment in patients with prior HE.
• To compare cognitive function in prior HE patients versus those who never experienced HE (no-HE).
• To conduct this evaluation in a multicenter setting.

Main Methods:

• 174 outpatients with cirrhosis were recruited from three centers.
• Participants underwent psychometric hepatic encephalopathy score (PHES) and inhibitory control testing (ICT).
• Testing was performed at baseline and repeated at least 7 days later to assess learning and changes over time.

Main Results:

• Patients with prior HE performed worse on PHES and ICT compared to no-HE patients at baseline.
• No-HE patients demonstrated significant learning improvement at both baseline and retesting.
• Prior HE patients showed no significant learning improvement at baseline or retesting, with minimal improvement in PHES sub-tests.

Conclusions:

• Prior HE is associated with persistent significant learning impairment, even with adequate medical therapy.
• These findings underscore the importance of preventing the first HE episode.
• Multicenter data confirm the long-term cognitive impact of hepatic encephalopathy.