Skip to main content

Advertisement

Log in

Visual attention orienting in liver cirrhosis without overt hepatic encephalopathy

  • Published:
Metabolic Brain Disease Aims and scope Submit manuscript

Abstract

The attention system in patients with liver cirrhosis has not yet been fully investigated. We therefore studied visual attention orienting in cirrhotic patients without overt hepatic encephalopathy. Seventy cirrhotic patients without overt hepatic encephalopathy (aged 57±10 yr., mean±s.d.) and 55 controls (aged 49±12 yr.) were enrolled. Visual attention orienting was evaluated by a computerized neuropsychological test. The Reitan A test, commonly used to detect subclinical hepatic encephalopathy, was used to evaluate mental performance. Psychometric test scores were reduced in cirrhotics compared to controls (attention test: neutral condition =495±149 vs. 401±98 msec; valid condition =434±110 vs. 398±84 msec; invalid condition =485±146 vs. 392±110 msec; p<0.001; Reitan A test =52±20 vs. 35±11 sec., p<0.001). The attention effect of the cue was found both in controls and cirrhotics; however, it was significantly higher in cirrhotics than in controls (61±111 vs. 33±41 msec; p<0.002). The attention effect was directly correlated with Reitan A test (r=0.23, p=0.05) in cirrhotics. In conclusion, in cirrhotic patients without overt hepatic encephalopathy, visual attention orienting was present and focusing to an indexed location had a higher effect on reaction time compared to controls, possibly because of reduced basal arousal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Bernthal, P., Hayes, A., Tarter, R.E., Van Thiel, D., Lecky, J., Hegedus, A. (1987). Cerebral CT scan abnormalities in cholestatic and hepatocellular disease and their relationship to neuropsychologic test performance.Hepatology 7:107–114.

    PubMed  Google Scholar 

  • Conn, H.O. (1977). Trail making and number connection test in the assessment of mental state in portal-systemic encephalopathy.Dig. Dis. Sci. 22:541–550.

    Article  Google Scholar 

  • Conn, H.O., Leevy, C.M., Vlahcevic, Z.R., Rodgers, J.B., Maddrey, W.C., Seeff, L., and Levy, L.L. (1977). Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy.Gastroenterology 72:573–583.

    PubMed  Google Scholar 

  • Eriksen, C.W., and Hoffman, J.E. (1972). Temporal and spatial characteristics of selective encoding from visual displays.Percept. Psychophys. 12:201–204.

    Google Scholar 

  • Finlayson, M.A.J., Johnson, K.A., and Reitan, R.M. (1977). Relationship of level of education to neuropsychological measures in brain-damaged and non-brain-damaged adults.J. Consult. Clin. Psychol. 45:536–42.

    Article  PubMed  Google Scholar 

  • Gitlin, N., Lewis, D.C., and Hinkley, L. (1986). The diagnosis and prevalence of subclinical hepatic encephalopathy in apparently healthy ambulant, non-shunted patients with cirrhosis.J. Hepatol. 3:75–82.

    Article  PubMed  Google Scholar 

  • Lockwood, A.H., Murphy, B.W., Donnelly, K.Z., Mahl, T.C., and Perini, S. (1993). Positron-emission tomographic localization of abnormalities of brain metabolism in patients with minimal hepatic encephalopathy.Hepatology 18:1061–1068.

    Article  PubMed  Google Scholar 

  • O'Carroll, R.E., Hayes, P.C., Ebmeier, K.P., Dougall, N., Murray, C., Best, J.J.K.et al. (1991). Regional cerebral blood flow and cognitive function in patients with chronic liver disease.The Lancet 2:1250–1253.

    Article  Google Scholar 

  • Petersen, S.E., Robinson, D.L., and Morris, J.D. (1987). Contributions of the pulvinar to visual spatial attention.Neuropsychology 25:97–105.

    Article  Google Scholar 

  • Posner, M., Cohen, Y., and Rafal, R. (1982). Neural systems and the control of spatial orienting.Philosophical transactions of the Royal Society of London (biol) 298:187–198.

    Google Scholar 

  • Posner, M.I., Early, T.S., Reiman, E., Pardo, P.J., and Dhawan, M. (1988). Asymmetries in hemispheric control of attention in schizophrenia.Arch. Gen. Psychiat. 45:814–821.

    PubMed  Google Scholar 

  • Posner, M.I., and Petersen, S.E. (1990). The attention system of the human brain.Ann. Rev. Neurosci. 13:25–42.

    Article  PubMed  Google Scholar 

  • Reitan, R.M. (1958). Validity of the trail making test as an indicator of organic brain damage.Percept. Mot. Skills 8:271–6.

    Google Scholar 

  • Sartori, G., Prior, M., and Valenti, N. (1993). Markers neuropsicologici nel soggetto HIV+ asintomatico.Arc. Psicol. Neurol. Psichiatr. 54:293–304.

    Google Scholar 

  • Schomerus, H., Hamster, W., Blunck, H., Reinhard, U., Mayer, K., Dolle, W. (1981). Latent portasystemic encephalopathy. Nature of cerebral functional defects and their effect on fitness to drive.Dig. Dis. Sci. 27:622–630.

    Article  Google Scholar 

  • Sood, G.K., Sarin, S.K., Mahaptra, J., and Broorer, S.L. (1989). Comparative efficacy of psychometric tests in detection of subclinical hepatic encephalopathy in nonalcoholic cirrhotics: Search for a rational approach.Am. J. Gastroenterol. 84:156–159.

    PubMed  Google Scholar 

  • Tarter, R.E., Edwards, K.L., and Van Thiel, D.H. (1988). Neuropsychological dysfunction due to liver disease. In:Medical Neuropsychology. The impact of disease on behavior (Tarter, Edwards, Van Thiel, Eds). Plenum Press; New York and London, pp. 75–98.

    Google Scholar 

  • Wurtz, R.H., Goldberg, H.E., and Robinson, D.L. (1980). Behavioral modulation of visual responses in monkeys.Prog. Psychobiol. Physiol. Psychol. 9:42–83.

    Google Scholar 

  • Zeegen, R., Drinkwater, J.E., and Dawson, A.M. (1970). Method for measuring cerebral dysfunction in patients with liver disease.Br. Med. J. 2:633–636.

    PubMed  Google Scholar 

  • Zeneroli, M.L., Cioni, G., Ventura, P., Russo, A.M., Venturini, I, Casalgrandi, G., and Ventura, E. (1992). Interindividual variability of the number connection test.J. Hepatol. 15:262–264. A0431006 00008 CS-SPJRNPDF [HEADSUP]

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Amodio, P., Marchetti, P., Del Piccolo, F. et al. Visual attention orienting in liver cirrhosis without overt hepatic encephalopathy. Metab Brain Dis 10, 335–345 (1995). https://doi.org/10.1007/BF02109363

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02109363

Key words

Navigation