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Metabolic Brain Disease

, Volume 20, Issue 2, pp 115–127 | Cite as

Attention Dysfunction in Cirrhotic Patients: An Inquiry on the Role of Executive Control, Attention Orienting and Focusing

  • Piero Amodio
  • Sami Schiff
  • Franco Del Piccolo
  • Daniela Mapelli
  • Angelo Gatta
  • Carlo Umiltà
Article

Abstract

Attention alterations are reported in cirrhotics. Aiming at clarifying attention functioning in cirrhotics, an inquiry on the functioning of the anterior (AAS) and the posterior (PAS) attention system was performed. Thirty-six cirrhotics without overt hepatic encephalopathy (24 with EEG or TMT-A alterations) and 16 matched control subjects were enrolled. The AAS was studied by the Stroop task measuring selective attention control, the PAS was studied by the Posner task and the Focus task measuring automatic covert orienting and visual focusing of attention respectively.

Cirrhotics presented a task-dependent psychomotor slowing (Stroop > Posner > Focus) with an increased percentage of errors in the incongruent condition of the Stroop task [F(1, 57) = 4.9, p < 0.03]. Class C patients had both a selective slowing [F(1, 33) = 4.3, p < 0.05] and an increased percentage of errors in the incongruent condition [F(1, 34) = 5.1, p < 0.05] compared to Class A–B patients and controls. The patients with an altered EEG performed the Stroop test significantly slowly than those without EEG alterations [F(1, 41) = 8.9, p < 0.01] and with a clear trend for a higher number of errors in the incongruent condition [F(1, 39) = 3.8, p < 0.06]. In contrast, attention orienting and focusing were maintained. In conclusion, the AAS is more sensitive than the PAS to the early stages of hepatic encephalopathy.

Key words

Attention liver cirrhosis TMT-A EEG attention focusing attention orienting divided attention 

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Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Piero Amodio
    • 1
    • 4
  • Sami Schiff
    • 1
    • 2
  • Franco Del Piccolo
    • 1
  • Daniela Mapelli
    • 1
    • 3
  • Angelo Gatta
    • 1
  • Carlo Umiltà
    • 3
  1. 1.Department of Clinical and Experimental MedicineCirmanmec University of PadovaItaly
  2. 2.Department of Neurological and Vision ScienceUniversity of VeronaItaly
  3. 3.Department of General PsychologyCirmanmec University of PadovaItaly
  4. 4.PadovaItaly

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