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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author Chao Ju
Longtao Yang
Zhongshang Dai
Yisong Wang
Chang Li
Wei Zhao
Yongfang Jiang
Haiyang Li
Jun Liu
author_facet Chao Ju
Longtao Yang
Zhongshang Dai
Yisong Wang
Chang Li
Wei Zhao
Yongfang Jiang
Haiyang Li
Jun Liu
author_sort Chao Ju
collection DOAJ
description 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.
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spelling doaj-art-b2c4b945c4af4c7db6939d6375ec4fd32025-08-20T02:30:54ZengElsevierBrain Research Bulletin1873-27472025-08-0122811141610.1016/j.brainresbull.2025.111416Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathyChao Ju0Longtao Yang1Zhongshang Dai2Yisong Wang3Chang Li4Wei Zhao5Yongfang Jiang6Haiyang Li7Jun Liu8Department of Radiology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, ChinaDepartment of Radiology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Infectious Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; FuRong Laboratory, Changsha, Hunan 410078, China; Clinical Research Center For Viral Hepatitis In Hunan Province, Hunan, ChinaDepartment of Radiology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Radiology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Radiology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Infectious Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; FuRong Laboratory, Changsha, Hunan 410078, China; Clinical Research Center For Viral Hepatitis In Hunan Province, Hunan, China; Corresponding author at: Department of Infectious Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China; Corresponding author.Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China; Department of Radiology Quality Control Center in Hunan Province, Changsha, China; Clinical Research Center for Medical Imaging in Hunan Province, Changsha, China; Corresponding author at: Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.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.http://www.sciencedirect.com/science/article/pii/S036192302500228XHepatitis B cirrhosisMinimal hepatic encephalopathyVoxel-based morphometryTract-based spatial statisticsDiffusion tensor image analysis along the perivascular space
spellingShingle Chao Ju
Longtao Yang
Zhongshang Dai
Yisong Wang
Chang Li
Wei Zhao
Yongfang Jiang
Haiyang Li
Jun Liu
Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy
Brain Research Bulletin
Hepatitis B cirrhosis
Minimal hepatic encephalopathy
Voxel-based morphometry
Tract-based spatial statistics
Diffusion tensor image analysis along the perivascular space
title Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy
title_full Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy
title_fullStr Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy
title_full_unstemmed Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy
title_short Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy
title_sort associations among neuropsychological performance brain structural alterations and glymphatic function in patients with minimal hepatic encephalopathy
topic Hepatitis B cirrhosis
Minimal hepatic encephalopathy
Voxel-based morphometry
Tract-based spatial statistics
Diffusion tensor image analysis along the perivascular space
url http://www.sciencedirect.com/science/article/pii/S036192302500228X
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