Brain Integrity Changes Underlying Cognitive and Functional Recovery Postliver Transplant Continue to Evolve Over 1...

Area of Science:

• Neuroscience
• Transplantation Medicine
• Radiology

Background:

• Brain recovery after liver transplant (LT) is observed early, but long-term effects remain unclear.
• Assessing changes in brain MRI parameters, cognition, and quality of life (HRQOL) beyond 6 months post-LT is crucial.

Purpose of the Study:

• To evaluate the changes in brain MRI parameters, cognitive function, and HRQOL between 6 and 12 months after LT.
• To understand the trajectory of neurological recovery and its correlation with imaging biomarkers.

Main Methods:

• Longitudinal study involving cirrhotic patients undergoing LT.
• Brain MRI, including magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), and voxel-based morphometry (VBM), was performed pre-LT, at 6 months, and 1 year post-LT.
• Cognitive tests and HRQOL questionnaires were administered at the same time points.

Main Results:

• Cognitive and HRQOL scores showed sustained improvement from pre-LT to 1 year post-LT.
• MRS indicated reduced glutamine+glutamate and increased myoinositol/choline, with a slower improvement rate between 6 and 12 months.
• DTI revealed continued white matter changes (increased diffusivity) in the posterior internal capsule.
• VBM demonstrated a steady increase in basal ganglia grey matter volume up to 1 year post-LT.

Conclusions:

• Cognition and HRQOL continue to improve up to 1 year post-LT, though at a decelerated rate after 6 months.
• Brain MRI shows persistent grey matter increases, while ammonia-related metabolites and white matter integrity show slower improvement rates at 1 year post-LT.