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PET and SPECT in Hepatic and Uraemic Encephalopathy

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PET and SPECT in Neurology

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Abstract

Liver or kidney failure can disturb brain function to a variable extent. If organ failure is treated successfully, brain function is normally at least in part restored. A broad spectrum of radiotracer imaging methods has been employed to measure correlates of brain function and thereby elucidate the pathophysiology of hepatic or uraemic encephalopathy. Measurements of regional cerebral perfusion as well as energy metabolism in hepatic encephalopathy (HE) mostly revealed reductions in areas (particularly the frontal cortex and cingulum) relevant for the typically observed functional deficits (e.g. in attention or movement initiation). PET studies demonstrated that in HE, brain uptake of the neurotoxic ammonia increases with its plasma concentration. Some studies using the biomarker C-11-PK11195 indicate the presence of neuroinflammation in HE. Different neuroreceptor systems have been studied in HE throughout demonstrating reduced binding – particularly to central GABA-A receptors and dopamine as well as serotonin transporters. In patients with chronic renal failure and particularly those with depressive mood, reductions of cerebral blood flow and energy metabolism have been demonstrated, primarily located in the frontal cortex.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Georg Berding & Frank Bengel

  2. Department of Neurology, Hannover Medical School, Hannover, Germany

    Karin Weissenborn

Authors
  1. Georg Berding
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  2. Frank Bengel
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  3. Karin Weissenborn
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Correspondence to Georg Berding .

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Editors and Affiliations

  1. Dept. of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F.J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Neurology, University Medical Center Groningen, Groningen, The Netherlands

    Klaus L. Leenders

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Berding, G., Bengel, F., Weissenborn, K. (2014). PET and SPECT in Hepatic and Uraemic Encephalopathy. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., Leenders, K. (eds) PET and SPECT in Neurology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54307-4_37

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