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Regional reduction in gray and white matter volume in brains of cirrhotic patients: voxel-based analysis of MRI

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Abstract

Chronic hepatic encephalopathy is a characteristically reversible neuropsychiatric disorder that occurs mainly in patients with liver cirrhosis. The brain regions critically involved in the pathophysiology of cirrhosis are not clear. Magnetic resonance imaging (MRI) with voxel-based morphometry (VBM) is a valuable tool for evaluating structural brain changes in many neurodegenerative diseases. We performed an MRI scan on 18 patients with liver cirrhosis and 16 age-matched healthy controls. We evaluated brain regional structural changes, regional differences and the relationship of these changes with the blood levels of ammonia and the results of neuropsychological tests in patients with cirrhosis. The VBM showed reduction in the volume of gray matter in the cerebellum and occipital lobe and in the volume of white matter in the cingulate, parietal, temporal, occipital lobe and precentral area in cirrhotic patients compared with controls. There were significant correlations between the volume of these regions with the plasma levels of ammonia and the results of neuropsychological tests. Voxel-based analysis of MRI revealed evidence for structural abnormalities of brain in patients with cirrhosis. Abnormal function in the above regions may account for the ammonia-mediated changes and neuropsychological deficits in hepatic encephalopathy.

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Abbreviations

MRI:

Magnetic resonance imaging

VBM:

Voxel-based morphometry

SPM:

Statistical parametric mapping

DARTEL:

Diffeomorphic anatomical registration through an exponentiated Lie algebra

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Acknowledgments

We are grateful to Keiko Takayama (Kuwana City Hospital) for her excellent technical support.

Disclosures

The authors declare that no conflict of interest exists concerning this paper.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan

    Motoh Iwasa, Rumi Mifuji-Moroka, Naoki Fujita, Yoshinao Kobayashi & Yoshiyuki Takei

  2. Department of Internal Medicine, Kuwana City Hospital, Kuwana, Japan

    Rumi Mifuji-Moroka & Yukihiko Adachi

  3. Department of Gastroenterology, Matsusaka City Hospital, Matsusaka, Japan

    Makoto Kuroda

  4. Department of Cardiology, Matsusaka City Hospital, Matsusaka, Japan

    Hideo Moroka

  5. Department of Immunology, Mie University Graduate School of Medicine, Tsu, Japan

    Esteban C. Gabazza

  6. Department of Nuclear Medicine, Saitama Medical University International Medical Center, Hidaka, Japan

    Hiroshi Matsuda

Authors
  1. Motoh Iwasa
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  2. Rumi Mifuji-Moroka
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  3. Makoto Kuroda
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  4. Hideo Moroka
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  5. Naoki Fujita
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  6. Yoshinao Kobayashi
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  7. Yukihiko Adachi
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  8. Esteban C. Gabazza
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  9. Hiroshi Matsuda
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  10. Yoshiyuki Takei
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Correspondence to Motoh Iwasa.

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Iwasa, M., Mifuji-Moroka, R., Kuroda, M. et al. Regional reduction in gray and white matter volume in brains of cirrhotic patients: voxel-based analysis of MRI. Metab Brain Dis 27, 551–557 (2012). https://doi.org/10.1007/s11011-012-9314-x

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  • DOI: https://doi.org/10.1007/s11011-012-9314-x

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