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Characterization of brain microstructural abnormalities in cirrhotic patients without overt hepatic encephalopathy using diffusion kurtosis imaging.

Authors
  • Sun, Qing1, 2, 3
  • Fan, Wenliang1, 2
  • Liu, Yuan1, 2
  • Zou, Yan1, 2
  • Wiseman, Natalie4
  • Kou, Zhifeng5, 6, 7
  • Han, Ping8, 9
  • 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. , (China)
  • 2 Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China. , (China)
  • 3 Department of Biomedical Engineering, Department of Radiology, Wayne State University, Detroit, MI, USA.
  • 4 Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
  • 5 Department of Biomedical Engineering, Department of Radiology, Wayne State University, Detroit, MI, USA. [email protected]
  • 6 Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA. [email protected]
  • 7 Department of Radiology, Wayne State University, Detroit, MI, USA. [email protected]
  • 8 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. [email protected] , (China)
  • 9 Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China. [email protected] , (China)
Type
Published Article
Journal
Brain Imaging and Behavior
Publisher
Springer-Verlag
Publication Date
Sep 11, 2019
Identifiers
DOI: 10.1007/s11682-019-00141-4
PMID: 31538276
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Cirrhosis is a major public health concern. However, little is known about the neurobiological mechanisms underlying brain microstructure alterations in cirrhotic patients. The purpose of this prospective study was to investigate brain microstructural alterations in cirrhosis with or without minimal hepatic encephalopathy (MHE) and their relationship with patients' neurocognitive performance and disease duration using voxel-based analysis of diffusion kurtosis imaging (DKI). DKI data were acquired from 30 cirrhotic patients with MHE, 31 patients without MHE (NMHE) and 59 healthy controls. All DKI-derived parametric maps were compared across the three groups to investigate their group differences. Correlation analyses were further performed to assess relationships between altered imaging parameters and clinical data. Voxel-based analysis of DKI data results showed that MHE/NMHE patients had increased radial diffusivity, axial diffusivity (AD) and mean diffusivity in addition to decreased axial kurtosis (AK) and fractional anisotropy of kurtosis in several regions. Compared to controls, these regions were primarily the cingulum, temporal and frontal cortices. The DKI metrics (i.e., AK and AD) were correlated with clinical variables in the two patient groups. In conclusion, DKI is useful for detecting brain microstructural abnormalities in MHE and NMHE patients. Abnormal DKI parameters suggest alterations in brain microstructural complexity in cirrhotic patients, which may contribute to the neurobiological basis of neurocognitive impairment. These results may provide additional information on the pathophysiology of cirrhosis.

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