Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction
AimsAlthough neural activity abnormalities have been reported in cirrhosis patients with minimal hepatic encephalopathy (MHE), the neurophysiological mechanisms underlying microstructural brain alterations remain poorly understood. This prospective study aimed to assess microstructural abnormalities...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2025.1600100/full |
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| author | Qing Sun Qing Sun Qing Sun Wenliang Fan Wenliang Fan Wenliang Fan Yuan Liu Yuan Liu Yuan Liu Zhifeng Kou Ping Han Ping Han Ping Han |
| author_facet | Qing Sun Qing Sun Qing Sun Wenliang Fan Wenliang Fan Wenliang Fan Yuan Liu Yuan Liu Yuan Liu Zhifeng Kou Ping Han Ping Han Ping Han |
| author_sort | Qing Sun |
| collection | DOAJ |
| description | AimsAlthough neural activity abnormalities have been reported in cirrhosis patients with minimal hepatic encephalopathy (MHE), the neurophysiological mechanisms underlying microstructural brain alterations remain poorly understood. This prospective study aimed to assess microstructural abnormalities in both gray matter and white matter of MHE patients by using diffusion kurtosis imaging (DKI), and to examine associations between these alterations and neurocognitive and clinical measurements.MethodsThirty-one Hepatitis B Virus-related cirrhotic patients without MHE (NMHE), thirty Hepatitis B Virus-related cirrhotic patients with MHE, and 59 gender-, age-, education-matched healthy controls underwent diffusional kurtosis imaging and neurocognitive assessments. We used tract-based spatial statistics (TBSS) analysis to estimate group differences of white matter (WM) microstructure and voxel-based morphometry analysis to determine gray matter (GM) abnormalities. Correlation analyses were further performed to assess relationships between altered diffusional parameters and clinical variables, such as neurocognitive performances and disease duration.ResultsThe TBSS analysis results showed that MHE patients had significantly decreased fractional anisotropy (FA) in the temporal part of the left superior longitudinal fasciculus and decreased kurtosis fractional anisotropy (KFA) in the left corticospinal tract and anterior thalamic radiation (p < 0.05, threshold-free cluster enhancement corrected). Notably, lower KFA in WM regions correlated with worse neurocognitive test scores in MHE patients. For GM, MHE patients exhibited increased volume of thalamus. No significant WM or GM differences were observed between NMHE patients and the other two groups.ConclusionMinimal hepatic encephalopathy patients demonstrated microstructural abnormalities in both WM and GM, predominantly affecting regions involved in cognitive, attention, and motor functions. These findings suggest that disruption of microstructural integrity may underlie the pathophysiological underpinnings of neurocognitive dysfunction in MHE, offering neuroimaging evidence for disease mechanisms. |
| format | Article |
| id | doaj-art-bc79dcb935d54b9d9fa311ae01188b48 |
| institution | Kabale University |
| issn | 1662-5161 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Human Neuroscience |
| spelling | doaj-art-bc79dcb935d54b9d9fa311ae01188b482025-08-20T03:51:29ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612025-07-011910.3389/fnhum.2025.16001001600100Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunctionQing Sun0Qing Sun1Qing Sun2Wenliang Fan3Wenliang Fan4Wenliang Fan5Yuan Liu6Yuan Liu7Yuan Liu8Zhifeng Kou9Ping Han10Ping Han11Ping Han12Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Precision Radiology and Interventional Medicine, Wuhan, ChinaHubei Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Precision Radiology and Interventional Medicine, Wuhan, ChinaHubei Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Precision Radiology and Interventional Medicine, Wuhan, ChinaHubei Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United StatesDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Precision Radiology and Interventional Medicine, Wuhan, ChinaHubei Key Laboratory of Molecular Imaging, Wuhan, ChinaAimsAlthough neural activity abnormalities have been reported in cirrhosis patients with minimal hepatic encephalopathy (MHE), the neurophysiological mechanisms underlying microstructural brain alterations remain poorly understood. This prospective study aimed to assess microstructural abnormalities in both gray matter and white matter of MHE patients by using diffusion kurtosis imaging (DKI), and to examine associations between these alterations and neurocognitive and clinical measurements.MethodsThirty-one Hepatitis B Virus-related cirrhotic patients without MHE (NMHE), thirty Hepatitis B Virus-related cirrhotic patients with MHE, and 59 gender-, age-, education-matched healthy controls underwent diffusional kurtosis imaging and neurocognitive assessments. We used tract-based spatial statistics (TBSS) analysis to estimate group differences of white matter (WM) microstructure and voxel-based morphometry analysis to determine gray matter (GM) abnormalities. Correlation analyses were further performed to assess relationships between altered diffusional parameters and clinical variables, such as neurocognitive performances and disease duration.ResultsThe TBSS analysis results showed that MHE patients had significantly decreased fractional anisotropy (FA) in the temporal part of the left superior longitudinal fasciculus and decreased kurtosis fractional anisotropy (KFA) in the left corticospinal tract and anterior thalamic radiation (p < 0.05, threshold-free cluster enhancement corrected). Notably, lower KFA in WM regions correlated with worse neurocognitive test scores in MHE patients. For GM, MHE patients exhibited increased volume of thalamus. No significant WM or GM differences were observed between NMHE patients and the other two groups.ConclusionMinimal hepatic encephalopathy patients demonstrated microstructural abnormalities in both WM and GM, predominantly affecting regions involved in cognitive, attention, and motor functions. These findings suggest that disruption of microstructural integrity may underlie the pathophysiological underpinnings of neurocognitive dysfunction in MHE, offering neuroimaging evidence for disease mechanisms.https://www.frontiersin.org/articles/10.3389/fnhum.2025.1600100/fullminimal hepatic encephalopathydiffusion kurtosis imagingtract-based spatial statisticswhite mattergray mattervoxel-based morphometry |
| spellingShingle | Qing Sun Qing Sun Qing Sun Wenliang Fan Wenliang Fan Wenliang Fan Yuan Liu Yuan Liu Yuan Liu Zhifeng Kou Ping Han Ping Han Ping Han Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction Frontiers in Human Neuroscience minimal hepatic encephalopathy diffusion kurtosis imaging tract-based spatial statistics white matter gray matter voxel-based morphometry |
| title | Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction |
| title_full | Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction |
| title_fullStr | Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction |
| title_full_unstemmed | Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction |
| title_short | Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction |
| title_sort | assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction |
| topic | minimal hepatic encephalopathy diffusion kurtosis imaging tract-based spatial statistics white matter gray matter voxel-based morphometry |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2025.1600100/full |
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