Related Experiment Video
Updated: Mar 9, 2026

Assessment of Memory Function in Pilocarpine-induced Epileptic Mice
Published on: June 4, 2020
Hepatic Encephalopathy Is Associated with Persistent Learning Impairments Despite Adequate Medical Treatment: A
Silvia Nardelli1, Sanath Allampati2, Oliviero Riggio1
1Division of Gastroenterology, Sapienza University of Rome, Rome, Italy.
Background:
Hepatic encephalopathy (HE) is considered reversible regarding mental status but may not be cognitively in single-center studies.
Aim:
To evaluate persistence of learning impairment in prior HE compared to those who never experienced HE (no-HE) in a multicenter study.
Methods:
A total of 174 outpatient cirrhotics from three centers (94 Virginia, 30 Ohio, and 50 Rome; 36 prior HE) underwent psychometric hepatic encephalopathy score (PHES) and inhibitory control (ICT) testing at baseline and then at least 7 days apart. ICT learning (change in 2nd half lures compared to 1st half) was compared between patient groups at both visits. Change in the PHES individual sub-tests and total score between visits was compared in both groups. US versus Italian trends were also analyzed.
Results:
HE patients had worse PHES and ICT results compared to no-HE patients at baseline. Significant improvement (1st half 7.1 vs. 2nd half 6.2, p < 0.0001) was observed in no-HE, but not in HE (1st half 7.9 vs. 2nd half 7.8, p = 0.1) at baseline. At retesting (median 20 days later), no-HE patients continued with significant learning (1st half 6.0 vs. 2nd half 5.4, p < 0.0001), while HE patients again did not improve (1st half 7.8 vs. 2nd half 6.9, p = 0.37). Between visits, no-HE patients improved significantly on four PHES sub-tests and overall score, while HE patients only improved on two sub-tests with similar overall PHES score. Trends were similar between US and Italian subjects.
Conclusion:
In this multicenter study, prior HE patients showed persistent significant learning impairment compared to those without prior HE, despite adequate medical therapy. This persistent change should increase efforts to reduce the first HE episode.
Related Concept Videos
Long-term Potentiation
Long-term Potentiation
Hebbian LTP
LTP can occur when...
Long-term Depression
Long-term Depression
Calcium Ion Concentration Mechanism
If over...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

