Microstructural brain abnormalities correlate with neurocognitive dysfunction in minimal hepatic encephalopathy: a...

Area of Science:

• Neuroimaging
• Diffusion Tensor Imaging
• Diffusion Kurtosis Imaging

Background:

• Minimal hepatic encephalopathy (MHE) is a subclinical complication of cirrhosis.
• Early diagnosis of MHE is crucial for timely intervention and management.
• Current diagnostic methods may not be sensitive enough for early MHE detection.

Purpose of the Study:

• To investigate the utility of diffusion kurtosis imaging (DKI) in diagnosing early MHE.
• To assess the correlation between DKI metrics and cognitive performance in cirrhosis patients.
• To identify potential neuroimaging biomarkers for MHE.

Main Methods:

• 116 cirrhosis patients (61 non-HE, 55 MHE) and 46 healthy controls underwent cognitive testing and DKI MRI.
• Voxel-based analysis (VBA) was used to calculate DKI metrics.
• Pearson correlation and ROC curve analysis were performed to evaluate diagnostic efficiency.

Main Results:

• MHE patients exhibited significant alterations in DKI metrics across various brain regions.
• Lower fractional anisotropy (FA) and higher mean diffusivity (MD) were observed in specific white matter tracts.
• Altered kurtosis metrics (MK, RK, AK) were also noted.
• Axial diffusivity (AD) in the forceps minor showed the highest diagnostic performance for MHE (AUC=0.801).

Conclusions:

• DKI can detect brain microstructure abnormalities associated with MHE.
• Certain altered DKI metrics, particularly AD, show promise as neuroimaging markers for early MHE diagnosis.
• These findings support the use of DKI in the clinical evaluation of cirrhosis patients.