Brain magnetic resonance spectroscopy in episodic hepatic encephalopathy

Brain magnetic resonance (MR) study has shown metabolic abnormalities and changes in water distribution of the brain tissue that may relate to the pathogenesis of hepatic encephalopathy (HE). We designed a study to investigate the disturbances in brain water and metabolites during episodic HE using...

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Detalles Bibliográficos
Autores: Chavarria, Laia|||0000-0002-7455-9929, Alonso, Juli, García-Martínez, Rita|||0000-0003-2159-2757, Simón Talero, Macarena|||0000-0002-1409-3936, Ventura-Cots, Meritxell|||0000-0001-9513-2855, Ramírez, Clara, Torrens, Maria|||0000-0003-3479-0066, Vargas Blasco, Víctor|||0000-0002-7190-6948, Rovira, Alex|||0000-0002-2132-6750, Córdoba Cardona, Juan
Tipo de recurso: artículo
Fecha de publicación:2013
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:306606
Acceso en línea:https://ddd.uab.cat/record/306606
https://dx.doi.org/urn:doi:10.1038/jcbfm.2012.173
Access Level:acceso abierto
Palabra clave:Acute hepatic encephalopathy
Blood-brain-barrier
Glutamine
Leukoaraiosis
Spectroscopy
Descripción
Sumario:Brain magnetic resonance (MR) study has shown metabolic abnormalities and changes in water distribution of the brain tissue that may relate to the pathogenesis of hepatic encephalopathy (HE). We designed a study to investigate the disturbances in brain water and metabolites during episodic HE using a 3-T MR scanner. Cirrhotic patients with different grades of HE underwent MR during hospitalization (n=18). The MR was repeated at 6 weeks' follow-up (n=14). The results were compared with those of a group of healthy volunteers (n=8). During episodic HE, brain diffusion-weighted imaging showed a high apparent diffusion coefficient (ADC) (12% to 14%) that decreased during follow-up (-1% to-4%). These disturbances were accompanied by high glutamine (581%), low choline (-31%), and low myo-inositol (-86%) peaks on MR spectroscopy. In overt HE, patients showed high glutamine that decreased during follow-up (-22%). In addition, these patients exhibited a rise in plasma S100 beta and enlargement of brain white-matter lesions. In conclusion, several disturbances detected by MR support the presence of impaired brain water homeostasis during episodic HE. Although astrocytes have a major role in this condition, brain edema during episodic HE may be extracellular and does not appear to be directly responsible for the development of neurologic manifestations.

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