Dynamic network reconfiguration in hepatitis B cirrhosis secondary to mild hepatic encephalopathy: a multilayer...

Static functional networks of the brain are disrupted in minimal hepatic encephalopathy (MHE), but their dynamic alterations are unknown. This observational study utilized multilayer network analysis to investigate dynamic network characteristics in hepatitis B cirrhosis (HBC) with or without MHE and assess their association with neurocognitive function (registry: https://ctms.xyeyy.com/iit/project/index; trial registration number: LYF20240134; date: 2024-07-31).

A total of 33 HBC patients [15 non-MHE (NMHE; HBC patients without MHE) and 18 MHE individuals], as well as 36 matched healthy controls (HCs), underwent neurocognitive assessments, resting-state functional magnetic resonance imaging (rs-fMRI), and clinical examinations. Dynamic network variations were quantified using network switching rates, and their relationships with clinical and neurocognitive parameters were evaluated.

Both HBC patients with and without MHE status exhibited a range of altered network switching rates compared to HCs. Specifically, differences were observed in subnetworks including somatomotor network (SMN), dorsal attention network (DAN), ventral attention network (VAN), frontoparietal network (FPN), and subcortical network (SUB), as well as in nodal regions such as the right precentral gyrus (rPrG), left fusiform gyrus (lFuG), left inferior parietal lobule (lIPL), and right hippocampus (rHipp). Furthermore, altered global level and lFuG switching rates positively correlated with Psychometric Hepatic Encephalopathy Score (PHES) (r=0.341, 0.339; P=0.004, 0.004, respectively, Bonferroni corrected).

This study firstly revealed that HBC patients exhibited imbalanced functional dynamics in subnetworks and nodes, suggesting a potential mechanism underlying cerebral dysfunction in MHE.