Metabolic Brain Disease

, Volume 25, Issue 1, pp 57–63 | Cite as

No oxygen delivery limitation in hepatic encephalopathy

  • Albert Gjedde
  • Susanne Keiding
  • Hendrik Vilstrup
  • Peter Iversen
Original Paper


Hepatic encephalopathy is a condition of reduced brain functioning in which both blood flow and brain energy metabolism declined. It is not known whether blood flow or metabolism is the primary limiting factor of brain function in this condition. We used calculations of mitochondrial oxygen tension to choose between cause and effect in three groups of volunteers, including healthy control subjects (HC), patients with cirrhosis of the liver without hepatic encephalopathy (CL), and patients with cirrhosis with acute hepatic encephalopathy. Compared to HC subjects, blood flow and energy metabolism had declined in all gray matter regions of the brain in patients with HE but not significantly in patients with CL. Analysis of flow-metabolism coupling indicated that blood flow declined in HE as a consequence of reduced brain energy metabolism implied by the calculation of increased mitochondrial oxygen tensions that patients with HE were unable to utilize. We ascribe the inability to use the delivered oxygen of patients with HE to a specific inhibition associated with oxidative metabolism in mitochondria.


Brain energy metabolism Cerebral blood flow Cerebral metabolic rate for oxygen Hepatic encephalopathy 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Albert Gjedde
    • 1
    • 2
    • 3
  • Susanne Keiding
    • 1
    • 4
  • Hendrik Vilstrup
    • 4
  • Peter Iversen
    • 1
  1. 1.Pathophysiology and Experimental Tomography CenterAarhus Hospital, Aarhus University HospitalsAarhusDenmark
  2. 2.Department of Neuroscience and PharmacologyUniversity of CopenhagenCopenhagenDenmark
  3. 3.Department of Neurology and NeurosurgeryMcGill UniversityMontrealCanada
  4. 4.Department of Hepatology VAarhus Hospital, Aarhus University HospitalsAarhusDenmark

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