, Volume 47, Issue 1, pp 27–34 | Cite as

Chemical shift magnetic resonance spectroscopy of cingulate grey matter in patients with minimal hepatic encephalopathy

  • Sergei Mechtcheriakov
  • Michael Schocke
  • André Kugener
  • Ivo W. Graziadei
  • Michael Mattedi
  • Hartmann Hinterhuber
  • Wolfgang Vogel
  • Josef Marksteiner
Diagnostic Neuroradiology


Minimal hepatic encephalopathy (MHE) is frequently diagnosed in patients with liver cirrhosis who do not show overt clinical cirrhosis-associated neurological deficits. This condition manifests primarily with visuo-motor and attention deficits. We studied the association between visuo-motor deficits and magnetic resonance spectroscopic parameters in cingulate grey matter and white matter of centrum semiovale in patients with liver cirrhosis. The data revealed an increase in the glutamate–glutamine/creatine ratio and a decrease in choline/creatine and inositol/creatine ratios in patients with liver cirrhosis. The analysis of the data showed that cirrhosis-associated deterioration of the visuo-motor function significantly correlates with a decrease in the choline/creatine ratio and an increase in N-acetylaspartate/choline in cingulate grey matter but not in the neighbouring white matter. Furthermore, the increase in the glutamate–glutamine/creatine ratio correlated significantly with the increase in the N-acetylaspartate/creatine ratio. These data suggest an association between altered choline, glutamate-glutamine and NAA metabolism in cingulate grey matter and symptoms of MHE, and underline the importance of differentiation between grey and white matter in magnetic resonance spectroscopic studies on patients with cirrhosis-associated brain dysfunction.


N-acetyl–N-aspartate Cingulate gyrus Choline Minimal hepatic encephalopathy Visuo-motor function Magnetic resonance spectroscopy 



We are thankful to Dr. G. Kemmler for support in the statistical analysis and to Mrs. Simone Auffinger and Dr. Th. Bodner for their technical assistance. The stipend for M. Mattedi was sponsored by Dr. Kolassa + Merz (Vienna).


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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Sergei Mechtcheriakov
    • 1
  • Michael Schocke
    • 2
  • André Kugener
    • 1
  • Ivo W. Graziadei
    • 3
  • Michael Mattedi
    • 1
  • Hartmann Hinterhuber
    • 1
  • Wolfgang Vogel
    • 3
  • Josef Marksteiner
    • 1
  1. 1.Department of General PsychiatryInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Department of Radiology IInnsbruck Medical UniversityInnsbruckAustria
  3. 3.Department of GastroenterologyInnsbruck Medical UniversityInnsbruckAustria

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