الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Liver cirrhosis is one of the leading causes of death worldwide. Patients with cirrhosis usually develop a mild form of hepatic encephalopathy (HE) known as minimal hepatic encephalopathy (MHE); characterized by mild cognitive impairment which cannot be clinically assessed, instead psychometric tests come in handy. Magnetic resonance studies, using diffusion tensor imaging (DTI), suggest that those patients may show white matter (WM) abnormalities. The aims of this work were: 1) to investigate the abnormalities in WM microstructure in MHE patients by means of tract-based spatial statistics (TBSS), 2) to evaluate the correlations between the WM abnormalities, if any, and the cognitive and motor functions impairment assessed by means of psychometric tests, 3) to assess whether there is a correlation between the WM abnormalities and some biochemical peripheral markers that proved to be robust in the diagnosis of MHE. Thirty subjects were recruited in this study (10 controls and 20 cirrhotic patients). Based on performance in different psychometric tests, cirrhotic patients were categorized into patients with MHE and patients without MHE. WM integrity for all the subjects was analyzed using DTI and TBSS. Different biochemical parameters were measured in blood. Only patients with MHE showed reduction in the overall WM microstructure integrity. This reduction was associated with an obvious decrease in fractional anisotropy (FA) and an increase in mean diffusivity (MD). The decrease in FA was correlated to the decline in performance in some Stroop tasks and bimanual coordination. The increase in MD was correlated to the decline in psychometric hepatic encephalopathy score (PHES) test, as well as bimanual and visuomotor coordination. It was also correlated to the increase in 3-Nitrotyrosine. These findings may suggest a relation between the decline in cognitive functions and the abnormalities and loss of integrity of the WM.