Clinical and radiological impact of liver transplantation for brain in cirrhosis patients without hepatic encephalopathy

Tetsuro Ishihara, Mizuki Ito, Yoshiki Niimi, Masashi Tsujimoto, Jo Senda, Yoshinari Kawai, Hirohisa Watanabe, Masatoshi Ishigami, Takashi Ito, Hideya Kamei, Yasuharu Onishi, Taro Nakamura, Hidemi Goto, Shinji Naganawa, Tetsuya Kiuchi, Gen Sobue

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective To elucidate the effect of liver transplantation (LT) on brain dysfunctions in cirrhotic patients who had no clinical evidence of hepatic encephalopathy (HE), we performed a prospective study of voxel-based diffusion tensor imaging (DTI) and detailed cognitive examination. Methods We assessed 12 consecutive patients as transplant candidates by DTI, with neurological and cognitive examinations just before and at 6 months after LT. Results After LT, cirrhotic patients showed significant improvement in visual reproduction, digit symbol, digit span, Stroop test, and Trail-making test scores, suggesting recovery of frontal-temporal function. As for voxel-based DTI, increased mean diffusivity (MD) and reduced fractional anisotropy (FA) values were found before LT in the frontal and temporal lobes of cirrhotic patients. After LT, the unusual FA and MD values observed in the frontal and temporal lobes preoperatively were significantly reduced. Conclusion End-stage cirrhotic patients without clinical evidence of HE showed increased MD and decreased FA values in both frontal and temporal lobes. These parameters improved after LT, in line with cognitive function. MD and FA values might be of value as a biomarker in end-stage cirrhotic patients for investigating brain tissue dysfunctions and evaluating the efficacy of LT.

Original languageEnglish
Pages (from-to)2341-2347
Number of pages7
JournalClinical Neurology and Neurosurgery
Volume115
Issue number11
DOIs
Publication statusPublished - 01-11-2013

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Hepatic Encephalopathy
Liver Transplantation
Fibrosis
Anisotropy
Brain
Diffusion Tensor Imaging
Frontal Lobe
Temporal Lobe
Trail Making Test
Stroop Test
Neurologic Examination
Cognition
Reproduction
Biomarkers
Prospective Studies
Transplants

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Ishihara, Tetsuro ; Ito, Mizuki ; Niimi, Yoshiki ; Tsujimoto, Masashi ; Senda, Jo ; Kawai, Yoshinari ; Watanabe, Hirohisa ; Ishigami, Masatoshi ; Ito, Takashi ; Kamei, Hideya ; Onishi, Yasuharu ; Nakamura, Taro ; Goto, Hidemi ; Naganawa, Shinji ; Kiuchi, Tetsuya ; Sobue, Gen. / Clinical and radiological impact of liver transplantation for brain in cirrhosis patients without hepatic encephalopathy. In: Clinical Neurology and Neurosurgery. 2013 ; Vol. 115, No. 11. pp. 2341-2347.
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abstract = "Objective To elucidate the effect of liver transplantation (LT) on brain dysfunctions in cirrhotic patients who had no clinical evidence of hepatic encephalopathy (HE), we performed a prospective study of voxel-based diffusion tensor imaging (DTI) and detailed cognitive examination. Methods We assessed 12 consecutive patients as transplant candidates by DTI, with neurological and cognitive examinations just before and at 6 months after LT. Results After LT, cirrhotic patients showed significant improvement in visual reproduction, digit symbol, digit span, Stroop test, and Trail-making test scores, suggesting recovery of frontal-temporal function. As for voxel-based DTI, increased mean diffusivity (MD) and reduced fractional anisotropy (FA) values were found before LT in the frontal and temporal lobes of cirrhotic patients. After LT, the unusual FA and MD values observed in the frontal and temporal lobes preoperatively were significantly reduced. Conclusion End-stage cirrhotic patients without clinical evidence of HE showed increased MD and decreased FA values in both frontal and temporal lobes. These parameters improved after LT, in line with cognitive function. MD and FA values might be of value as a biomarker in end-stage cirrhotic patients for investigating brain tissue dysfunctions and evaluating the efficacy of LT.",
author = "Tetsuro Ishihara and Mizuki Ito and Yoshiki Niimi and Masashi Tsujimoto and Jo Senda and Yoshinari Kawai and Hirohisa Watanabe and Masatoshi Ishigami and Takashi Ito and Hideya Kamei and Yasuharu Onishi and Taro Nakamura and Hidemi Goto and Shinji Naganawa and Tetsuya Kiuchi and Gen Sobue",
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Ishihara, T, Ito, M, Niimi, Y, Tsujimoto, M, Senda, J, Kawai, Y, Watanabe, H, Ishigami, M, Ito, T, Kamei, H, Onishi, Y, Nakamura, T, Goto, H, Naganawa, S, Kiuchi, T & Sobue, G 2013, 'Clinical and radiological impact of liver transplantation for brain in cirrhosis patients without hepatic encephalopathy', Clinical Neurology and Neurosurgery, vol. 115, no. 11, pp. 2341-2347. https://doi.org/10.1016/j.clineuro.2013.08.015

Clinical and radiological impact of liver transplantation for brain in cirrhosis patients without hepatic encephalopathy. / Ishihara, Tetsuro; Ito, Mizuki; Niimi, Yoshiki; Tsujimoto, Masashi; Senda, Jo; Kawai, Yoshinari; Watanabe, Hirohisa; Ishigami, Masatoshi; Ito, Takashi; Kamei, Hideya; Onishi, Yasuharu; Nakamura, Taro; Goto, Hidemi; Naganawa, Shinji; Kiuchi, Tetsuya; Sobue, Gen.

In: Clinical Neurology and Neurosurgery, Vol. 115, No. 11, 01.11.2013, p. 2341-2347.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical and radiological impact of liver transplantation for brain in cirrhosis patients without hepatic encephalopathy

AU - Ishihara, Tetsuro

AU - Ito, Mizuki

AU - Niimi, Yoshiki

AU - Tsujimoto, Masashi

AU - Senda, Jo

AU - Kawai, Yoshinari

AU - Watanabe, Hirohisa

AU - Ishigami, Masatoshi

AU - Ito, Takashi

AU - Kamei, Hideya

AU - Onishi, Yasuharu

AU - Nakamura, Taro

AU - Goto, Hidemi

AU - Naganawa, Shinji

AU - Kiuchi, Tetsuya

AU - Sobue, Gen

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Objective To elucidate the effect of liver transplantation (LT) on brain dysfunctions in cirrhotic patients who had no clinical evidence of hepatic encephalopathy (HE), we performed a prospective study of voxel-based diffusion tensor imaging (DTI) and detailed cognitive examination. Methods We assessed 12 consecutive patients as transplant candidates by DTI, with neurological and cognitive examinations just before and at 6 months after LT. Results After LT, cirrhotic patients showed significant improvement in visual reproduction, digit symbol, digit span, Stroop test, and Trail-making test scores, suggesting recovery of frontal-temporal function. As for voxel-based DTI, increased mean diffusivity (MD) and reduced fractional anisotropy (FA) values were found before LT in the frontal and temporal lobes of cirrhotic patients. After LT, the unusual FA and MD values observed in the frontal and temporal lobes preoperatively were significantly reduced. Conclusion End-stage cirrhotic patients without clinical evidence of HE showed increased MD and decreased FA values in both frontal and temporal lobes. These parameters improved after LT, in line with cognitive function. MD and FA values might be of value as a biomarker in end-stage cirrhotic patients for investigating brain tissue dysfunctions and evaluating the efficacy of LT.

AB - Objective To elucidate the effect of liver transplantation (LT) on brain dysfunctions in cirrhotic patients who had no clinical evidence of hepatic encephalopathy (HE), we performed a prospective study of voxel-based diffusion tensor imaging (DTI) and detailed cognitive examination. Methods We assessed 12 consecutive patients as transplant candidates by DTI, with neurological and cognitive examinations just before and at 6 months after LT. Results After LT, cirrhotic patients showed significant improvement in visual reproduction, digit symbol, digit span, Stroop test, and Trail-making test scores, suggesting recovery of frontal-temporal function. As for voxel-based DTI, increased mean diffusivity (MD) and reduced fractional anisotropy (FA) values were found before LT in the frontal and temporal lobes of cirrhotic patients. After LT, the unusual FA and MD values observed in the frontal and temporal lobes preoperatively were significantly reduced. Conclusion End-stage cirrhotic patients without clinical evidence of HE showed increased MD and decreased FA values in both frontal and temporal lobes. These parameters improved after LT, in line with cognitive function. MD and FA values might be of value as a biomarker in end-stage cirrhotic patients for investigating brain tissue dysfunctions and evaluating the efficacy of LT.

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