Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy

Brain anatomical alterations in gray matter(GM), white matter(WM), and glymphatic system(GS) in patients with hepatitis B cirrhosis(HBC) with minimal hepatic encephalopathy(MHE) remain to be clarified. A total of 33 healthy controls and 37 patients with treatment-native primary HBC (further subdivid...

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Main Authors: Chao Ju, Longtao Yang, Zhongshang Dai, Yisong Wang, Chang Li, Wei Zhao, Yongfang Jiang, Haiyang Li, Jun Liu
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Brain Research Bulletin
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Online Access:http://www.sciencedirect.com/science/article/pii/S036192302500228X
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Summary:Brain anatomical alterations in gray matter(GM), white matter(WM), and glymphatic system(GS) in patients with hepatitis B cirrhosis(HBC) with minimal hepatic encephalopathy(MHE) remain to be clarified. A total of 33 healthy controls and 37 patients with treatment-native primary HBC (further subdivided into HBC in MHE group[MHE] and HBC in non-MHE group[NMHE]) participated in neuroimaging study with three-dimensional T1 and a half q-space Cartesian grid diffusion model. Group differences in regional GM volume(GMV) were assessed using voxel-based morphometry(VBM) analysis. Differences in WM diffusion metrics were compared using tract-based spatial statistics(TBSS) analysis. Diffusion tensor image analysis along the perivascular space(DTI-ALPS) was employed to evaluate GS function. Compared to healthy control group (HC), GMV was reduced in MHE group, mainly in the vermis, bilateral pallidum, and right putamen, but was increased in right lateral geniculate thalamus(Thal_LGN_R) and left pulvinar medial thalamus(Thal_PuM_L). MHE patients displayed greater isotropic volume fraction(ISOVF) in the right sagittal stratum, right superior longitudinal fasciculus, left fornix(cres)/stria terminalis, left corticospinal tract, left cerebral peduncle, and left cingulum (hippocampus) than HC. DTI-ALPS was significantly downregulated in MHE patients. It revealed cortical changes, low-grade WM edema, and GS disorders at the early stage of chronic HBC, which will aid in MHE identification.
ISSN:1873-2747