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Psychometric tests for diagnosing minimal hepatic encephalopathy

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Abstract

While it is consensus that minimal hepatic encephalopathy (mHE) has significant impact on a patient’s daily living, and thus should be diagnosed and treated, there is no consensus about the optimal diagnostic tools. At present the most frequently used psychometric methods for diagnosing minimal hepatic encephalopathy are the Inhibitory Control Test and the Psychometric Hepatic Encephalopathy Score PHES. Another frequently used method is Critical Flicker Frequency. The PHES and the Repeatable Battery for the Assessment of Neuropsychological Status have been recommended for diagnosing mHE by a working party commissioned by the International Society for Hepatic Encephalopathy and Nitrogen Metabolism. Recently the Continuous Reaction Time Test, which has been used in the 1980ies, has gained new interest. Today, no data are available that allow to decide which of these methods is the most appropriate. In fact, even basic information such as dependence on age, sex and education or influence of diseases that frequently accompany liver cirrhosis upon test results is missing for most of them. Future studies must address these questions to improve diagnosis of mHE.

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References

  • Amodio P, Montagnese S, Gatta A, Morgan MY (2004) Characteristics of minimal hepatic encephalopathy. Metab Brain Dis 19(3–4):253–67

    Article  PubMed  Google Scholar 

  • Amodio P, Ridola L, Schiff S, Montagnese S, Pasquale C, Nardelli S, Pentassuglio I, Trezza M, Marzano C, Flaiban C, Angeli P, Cona G, Bisiacchi P, Gatta A, Riggio O (2010) Improving the inhibitory control task to detect minimal hepatic encephalopathy. Gastroenterology 139(2):510–518

    Article  PubMed  Google Scholar 

  • Bajaj JS, Saeian K, Verber MD, Hischke D, Hoffmann RG, Franco J, Varma RR, Rao SM (2007) Inhibitory Control Test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy. Am J Gastroenterol 102:754–760

    Article  PubMed  Google Scholar 

  • Elsass P, Christensen SE, Ranek L, Theilgaard A, Tygstrup N (1981) Continuous reaction time in patients with hepatic encephalopathy. A quantitative measure of changes in consciousness. Scand J Gastroent 16:441–447

    Article  PubMed  CAS  Google Scholar 

  • Elsass P, Christensen SE, Jorgensen F, Mortensen EL, Vilstrup H (1984) Number connection test and continuous reaction times in assessment of organic and metabolic encephalopathy: a comparative study. Acta pharmacol et toxicol 54:115–119

    Article  CAS  Google Scholar 

  • Kircheis G, Wettstein M, Timmermann L, Schnitzler A, Häussinger D (2002) Critical flicker frequency for quantification of low-grade hepatic encephalopathy. Hepatology 35:357–366

    Article  PubMed  Google Scholar 

  • Lauridsen MM, Jepsen P, Vilstrup H (2011) Critical flicker frequency and continuous reaction times for the diagnosis of minimal hepatic encephalopathy: a comparative study of 154 patients with liver disease. Metab Brain Dis 26(2):135–139

    Article  PubMed  Google Scholar 

  • Lauridsen MM, Grønbæk H, Næser EB, Leth ST, Vilstrup H (2012) Gender and age effects on the continuous reaction times method in volunteers and patients with cirrhosis. Metab Brain Dis [Epub ahead of print]. doi:10.1007/s11011-012-9318-6

  • Lockwood AH (2000) What's in a name? Improving the care of cirrhotics. J Hepatol 32(5):859–861

    Article  PubMed  CAS  Google Scholar 

  • Lockwood AH, Weissenborn K, Bokemeyer M, Tietge U, Burchert W (2002) Correlations between cerebral glucose metabolism and neuropsychological test performance in nonalcoholic cirrhotics. Metab Brain Dis 17(1):29–40

    Article  PubMed  Google Scholar 

  • Randolph C (1998) The repeatable battery for the assessment of neuropsychological status (RBANS). The Psychological Corporation, San Antonio

    Google Scholar 

  • Randolph C, Hilsabeck R, Kato A, Kharbanda P, Li YY, Mapelli D, Ravdin LD, Romero-Gomez M, Stracciari A, Weissenborn K, International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN), International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) (2009) Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines. Liver Internat 29(5):629–635

    Article  Google Scholar 

  • Schomerus H, Hamster W (1998) Neuropsychological aspects of portal-systemic encephalopathy. Metab Brain Dis 13(4):361–377

    Article  PubMed  CAS  Google Scholar 

  • Smith JM, Misiak H (1976) Critical Flicker Frequency (CFF) and psychotropic drugs in normal human subjects—a review. Psychopharmacology 47:175–182

    Article  CAS  Google Scholar 

  • Weissenborn K, Ennen JC, Schomerus H, Rückert N, Hecker H (2001) Neuropsychological characterization of hepatic encephalopathy. J Hepatol 34:768–773

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

The author has been funded by the German Federal Ministry of Education and Research within the Integrated Research and Treatment Center Transplantation at Hannover Medical School

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The author declares no conflict of interest.

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Correspondence to Karin Weissenborn.

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Weissenborn, K. Psychometric tests for diagnosing minimal hepatic encephalopathy. Metab Brain Dis 28, 227–229 (2013). https://doi.org/10.1007/s11011-012-9336-4

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  • DOI: https://doi.org/10.1007/s11011-012-9336-4

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