Altered dynamic spontaneous neural activity in minimal hepatic encephalopathy
Jie-Ru Guo1, Jia-Yan Shi2, Qiu-Yi Dong2
1Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China.
Frontiers in Neurology
|September 5, 2022
Summary
Dynamic brain activity changes in minimal hepatic encephalopathy (MHE) were identified using dynamic amplitude of low-frequency fluctuation (dALFF) variability. This metric may help distinguish MHE patients and serve as a biomarker for the condition.
Area of Science:
- Neuroscience
- Medical Imaging
- Hepatology
Background:
- Minimal hepatic encephalopathy (MHE) is associated with abnormal regional neural activity.
- Brain activity is inherently dynamic, suggesting temporal variability is crucial for understanding neurological conditions.
- Previous studies analyzed static amplitude of low-frequency fluctuation (ALFF), but MHE-related dynamic alterations require further investigation.
Purpose of the Study:
- To evaluate the temporal variability of ALFF (dynamic ALFF or dALFF) to reveal MHE-related alterations in spontaneous neural activity.
- To assess the correlation between dALFF variability and neurocognitive performance in cirrhotic patients.
- To determine the potential of dALFF variability as a biomarker for identifying MHE.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) was performed on 29 healthy controls and 49 cirrhotic patients (20 MHE, 29 non-MHE).
- Dynamic ALFF (dALFF) variability was calculated using a sliding-window approach to assess temporal dynamics of neural activity.
- Correlation analysis with Psychometric Hepatic Encephalopathy Score (PHES) and receiver operating characteristic (ROC) curve analysis were conducted.
Main Results:
- dALFF variability in the bilateral precuneus/posterior cingulate gyrus and left middle frontal gyrus decreased progressively from NHE to MHE groups.
- dALFF variability in the bilateral precuneus/posterior cingulate gyrus positively correlated with neurocognitive performance in cirrhotic patients (r = 0.383, P = 0.007).
- dALFF variability in the bilateral precuneus/posterior cingulate gyrus showed moderate power in distinguishing NHE from MHE patients (AUC = 0.712, P = 0.012).
Conclusions:
- Aberrant dynamic brain function exists in MHE, potentially underlying cognitive impairments and disease development.
- dALFF variability analysis can facilitate the identification of new biomarkers for MHE.
- Dynamic neural activity patterns offer insights into the pathophysiology of MHE.
