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Subtle impairments of cognitive function may be an important cause of occupational and psychosocial morbidity in patients with chronic liver disease. Correlation of structural brain abnormalities with cognitive deficits has yielded inconsistent results. 10 patients with cirrhotic liver disease were compared with 10 age, education, and intelligence matched control subjects. Neuropsychological assessment revealed significant overall cognitive impairments in cirrhotic patients compared with controls (p = 0.02). Regional cerebral blood flow was measured by single photon emission computed tomography (SPET or SPECT) and showed increased uptake of radiotracer in the right and left posterior parts of the basal ganglia and right occipital lobe, together with reduced uptake in the right anterior cingulate region. The degree of cognitive impairment was directly correlated with functional abnormalities in the basal ganglia and limbic cortex (p less than 0.05). Our results suggest that impaired cognitive status may be associated with abnormalities of regional brain function in patients with chronic liver disease. Since these deficits are clinically inapparent, our findings have important implications for identification and management of patients with chronic liver disease.

Original publication

DOI

10.1016/0140-6736(91)92920-w

Type

Journal article

Journal

Lancet

Publication Date

25/05/1991

Volume

337

Pages

1250 - 1253

Keywords

Analysis of Variance, Brain, Cholangitis, Sclerosing, Chronic Disease, Cognition, Cognition Disorders, Female, Humans, Liver Cirrhosis, Alcoholic, Liver Cirrhosis, Biliary, Liver Diseases, Male, Middle Aged, Regional Blood Flow, Tomography, Emission-Computed, Single-Photon