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Structural and functional abnormalities of thalamic subregions in minimal hepatic encephalopathy
Li-Min Cai1, Shao-Peng Zhuang2, Zi-Wei Cai2
1Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Purpose:
The thalamus, which consists of multiple subregions, has been of particular interest in the study of minimal hepatic encephalopathy (MHE). This study aimed to identify abnormalities of the thalamic subregions in patients with MHE and their associations with cognitive performance.
Methods:
Two groups of patients-30 patients with cirrhosis with MHE (the MHE group) and 48 patients with cirrhosis without MHE (the NHE group)-and 42 healthy controls (the HC group) underwent resting-state functional and structural magnetic resonance imaging. A histologically based atlas was used to segment the thalamus into 25 nuclei and subsequently group the thalamus into 6 subregions. Volume and mean regional homogeneity (mReHo, metrics reflecting local brain activity) were assessed in six thalamic subregions per hemisphere and the entire thalamus, and group differences were analyzed. Correlation analyses were conducted to explore associations between neuroimaging changes and clinical performance.
Results:
The MHE group showed increased volume in the bilateral posterior thalamic subregions (false-discovery rate [FDR]-corrected P < 0.05). Functionally, the MHE group showed increased mReHo values in the bilateral posterior, bilateral intralaminar, and left ventral thalamic subregions (FDR-corrected P < 0.05). Notably, both significant structural and functional alterations showed a progressive increase from NHE group to MHE group. These alterations in the thalamic subregions of patients with cirrhosis were significantly correlated with performance on neurocognitive tests (FDR-corrected P < 0.05).
Conclusion:
Our findings support the role of thalamic subregional alterations in the pathophysiology of MHE and highlight their potential as neuroimaging markers for early detection of MHE-related cognitive decline.
Insights
Thalamic subregion alterations are linked to cognitive decline in minimal hepatic encephalopathy (MHE). Structural and functional brain changes in MHE patients correlate with neurocognitive test performance, suggesting potential for early MHE detection.
Area of Science:
- Neuroimaging
- Neurology
- Hepatology
Background:
- Minimal hepatic encephalopathy (MHE) is a neurological complication of liver cirrhosis.
- The thalamus, a key brain structure, is implicated in cognitive function and has multiple subregions.
- Understanding thalamic abnormalities in MHE is crucial for diagnosing and managing cognitive impairment.
Purpose of the Study:
- To identify structural and functional abnormalities in thalamic subregions of patients with MHE.
- To investigate the association between these thalamic alterations and cognitive performance in MHE patients.
Main Methods:
- Used resting-state functional and structural MRI on three groups: MHE patients, non-MHE cirrhosis patients, and healthy controls.
- Segmented the thalamus into 25 nuclei, grouped into 6 subregions, and analyzed volume and mean regional homogeneity (mReHo).
- Performed correlation analyses between neuroimaging findings and neurocognitive test results.
Main Results:
- Patients with MHE exhibited increased volume in bilateral posterior thalamic subregions.
- Increased mReHo values were observed in bilateral posterior, bilateral intralaminar, and left ventral thalamic subregions in the MHE group.
- Both structural and functional thalamic alterations progressed from healthy controls to non-MHE patients to MHE patients and correlated significantly with cognitive performance.
Conclusions:
- Thalamic subregional alterations play a significant role in the pathophysiology of MHE.
- These identified thalamic changes can serve as potential neuroimaging markers for the early detection of MHE-related cognitive decline.
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