The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis
Abstract Background Minimal hepatic encephalopathy (MHE) is one of the most debilitating complications of hepatic cirrhosis, and visual electrophysiology, visual evoked potential (VEP) has long been used for MHE diagnosis. This technique only produces a summed response that is greatly dominated by t...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12883-025-04031-9 |
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| author | Reem M. Sabry Osama Hamad Hossam Eldin Mohamed Khalil Sahar Ibrahim Mohammed Ragaey Ahmad Eid Hanan Hosny |
| author_facet | Reem M. Sabry Osama Hamad Hossam Eldin Mohamed Khalil Sahar Ibrahim Mohammed Ragaey Ahmad Eid Hanan Hosny |
| author_sort | Reem M. Sabry |
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| description | Abstract Background Minimal hepatic encephalopathy (MHE) is one of the most debilitating complications of hepatic cirrhosis, and visual electrophysiology, visual evoked potential (VEP) has long been used for MHE diagnosis. This technique only produces a summed response that is greatly dominated by the macular region. Multifocal visual evoked potential (mfVEP) imaging minimizes these limitations because it allows topographic recording of the optic nerve and visual cortex. The aim of this study was to detect minimal hepatic encephalopathy among cirrhotic patients using the mfVEP in comparison to the validated psychometric hepatic encephalopathy score (PHES), paired associative learning (PAL) and the Benton visual retention test (BVRT). Methods Forty-five patients with compensated hepatic cirrhosis were enrolled in our study and compared to 45 normal controls who were matched for age, sex and educational level. Both groups underwent psychological tests (PHES, PAL, BVRT) and neurophysiological tests (mfVEP). Results 1According to the validated PHES, 14 patients were found to have MHE, 15 patients were found to have abnormal mfVEP, and abnormalities in the BVRT and PAL were found in 11 and 10 patients, respectively. 2-mfVEP showed the highest sensitivity in the detection of MHE in reference to the PHES. 3- The mfVEP test and potentially the BVRT have the advantage of detecting subtle abnormalities in non-MHE cirrhotic patients, for further research and follow-up are needed. Conclusion mfVEP demonstates promising results for objective early detection of MHE, with a sensitivity of approximately 92.9%. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
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| series | BMC Neurology |
| spelling | doaj-art-21f48422ab4846cbbb1e17490fb143142025-02-09T12:43:11ZengBMCBMC Neurology1471-23772025-02-0125111010.1186/s12883-025-04031-9The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosisReem M. Sabry0Osama Hamad1Hossam Eldin Mohamed Khalil2Sahar Ibrahim Mohammed3Ragaey Ahmad Eid4Hanan Hosny5Department of Clinical Neurophysiology (Neuro-Diagnostic and Research Center), Faculty of Medicine, Beni-Suef UniversityDepartment of Gastroenterology, Hepatology and Infectious Diseases (Tropical Medicine department), Faculty of Medicine, Beni-Suef UniversityDepartment of Ophthalmology, Faculty of Medicine, Beni-Suef UniversityDepartment of Ophthalmology, Faculty of Medicine, Beni-Suef UniversityDepartment of Gastroenterology, Hepatology and Infectious Diseases (Tropical Medicine department), Faculty of Medicine, Beni-Suef UniversityDepartment of Clinical Neurophysiology (Neuro-Diagnostic and Research Center), Faculty of Medicine, Beni-Suef UniversityAbstract Background Minimal hepatic encephalopathy (MHE) is one of the most debilitating complications of hepatic cirrhosis, and visual electrophysiology, visual evoked potential (VEP) has long been used for MHE diagnosis. This technique only produces a summed response that is greatly dominated by the macular region. Multifocal visual evoked potential (mfVEP) imaging minimizes these limitations because it allows topographic recording of the optic nerve and visual cortex. The aim of this study was to detect minimal hepatic encephalopathy among cirrhotic patients using the mfVEP in comparison to the validated psychometric hepatic encephalopathy score (PHES), paired associative learning (PAL) and the Benton visual retention test (BVRT). Methods Forty-five patients with compensated hepatic cirrhosis were enrolled in our study and compared to 45 normal controls who were matched for age, sex and educational level. Both groups underwent psychological tests (PHES, PAL, BVRT) and neurophysiological tests (mfVEP). Results 1According to the validated PHES, 14 patients were found to have MHE, 15 patients were found to have abnormal mfVEP, and abnormalities in the BVRT and PAL were found in 11 and 10 patients, respectively. 2-mfVEP showed the highest sensitivity in the detection of MHE in reference to the PHES. 3- The mfVEP test and potentially the BVRT have the advantage of detecting subtle abnormalities in non-MHE cirrhotic patients, for further research and follow-up are needed. Conclusion mfVEP demonstates promising results for objective early detection of MHE, with a sensitivity of approximately 92.9%.https://doi.org/10.1186/s12883-025-04031-9Multifocal visual evoked potentialsHepatic cirrhosisMinimal hepatic encephalopathyPsychometric hepatic encephalopathy score |
| spellingShingle | Reem M. Sabry Osama Hamad Hossam Eldin Mohamed Khalil Sahar Ibrahim Mohammed Ragaey Ahmad Eid Hanan Hosny The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis BMC Neurology Multifocal visual evoked potentials Hepatic cirrhosis Minimal hepatic encephalopathy Psychometric hepatic encephalopathy score |
| title | The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis |
| title_full | The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis |
| title_fullStr | The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis |
| title_full_unstemmed | The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis |
| title_short | The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis |
| title_sort | role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis |
| topic | Multifocal visual evoked potentials Hepatic cirrhosis Minimal hepatic encephalopathy Psychometric hepatic encephalopathy score |
| url | https://doi.org/10.1186/s12883-025-04031-9 |
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