We studied cognitive profile, cognitive evoked potentials (CEP), and metabolic changes by proton magnetic resonance spectroscopy (H1-MRS) in neurologically asymptomatic patients with liver cirrhosis (LC).
We included 25 patients with LC and 32 healthy controls. The neuropsychological battery included Wechsler Adult Intelligence Scale, Trailmaking test (Part A and B), Token test, Word Fluency tests, logical memory (immediate and delayed recall), Color Form Sorting Test, Finger Tapping (right and left hand), and Beck depression scale. CEP was measured by passive and active oddball procedure (Biosemi ActiveTwo equipment). H1- MRS examinations were performed on 1.5 T scanner with single voxel PRESS technique. Three voxels of 8 cm3 were positioned in white and gray matter cortex and globus pallidus.
80% of patients with LC presented with a dysfunction in the following domains of cognition: performance intelligence, attention, learning and memory. Verbal functions were well preserved. Patients with LC had higher absolute values of both N1 and P2 components amplitude (F(1,24)=4.01, p=0.056; F(1,24) =5.71 p=0.025; respectively) and higher mean N1 P2 complex value (F(1,24)=8.07, p=0.009, at the vertex) in response to deviant stimuli. Patients with LC had a significant reduction of mI/Cr ratio as compared to controls (0,062 ± 0,037 vs. 0,117 ± 0,09, p<0.05) and no changes in Cho/Cr and NAA/Cr ratios.
A high percentage of patients with LC and without any neurological deficit have cognitive dysfunctions in non verbal domains and lower efficiency of brain processing. The significant reduction of mI/Cr ratio suggests the alteration of glial function.

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