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Abnormal baseline brain activity in patients with HBV-related cirrhosis without overt hepatic encephalopathy revealed by resting-state functional MRI

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Abstract

Neurocognitive dysfunction of varying degrees is common in patients with hepatitis B virus-related cirrhosis (HBV-RC) without overt hepatic encephalopathy (OHE). However, the neurobiological mechanisms underlying these dysfunctions are not well understood. We sought to identify changes in the neural activity of patients with HBV-RC without OHE in the resting state by using the amplitude of low-frequency fluctuation (ALFF) method and to determine whether these changes were related to impaired cognition. Resting-state functional MRI data from 30 patients with HBV-RC and 30 healthy controls matched for age, sex, and years of education were compared to determine any differences in the ALFF between the two groups. Cognition was measured with the psychometric hepatic encephalopathy score (PHES), and the relationship between these scores and ALFF variation was assessed. Compared with controls, patients showed widespread lower standardized ALFF (mALFF) values in visual association areas (bilateral lingual gyrus, middle occipital gyrus, and left inferior temporal gyrus), motor-related areas (bilateral precentral gyrus, paracentral lobule, and right postcentral gyrus), and the default mode network (bilateral cuneus/precuneus and inferior parietal lobule). Higher mALFF values were found in the bilateral orbital gyrus/rectal gyrus. In patients, mALFF values were significantly positive correlated with the PHES in the right middle occipital gyrus and bilateral precentral gyrus. Our findings of resting-state abnormalities in patients with HBV-RC without OHE suggest that neurocognitive dysfunction in patients with HBV-RC without OHE may be caused by abnormal neural activity in multiple brain regions.

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Abbreviations

HBV-RC:

HBV-related cirrhosis

OHE:

Overt hepatic encephalopathy

ALFF:

Amplitude of low-frequency fluctuation

mALFF:

Standardized amplitude of low-frequency fluctuation

PHES:

Psychometric hepatic encephalopathy score

HE:

Hepatic encephalopathy

fMRI:

Functional MRI

BOLD:

Blood oxygenation level-dependent

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Acknowledgments

We thank the participants who magnanimously donate their time to participate in this study. Also, the authors are highly grateful to the anonymous reviewers for their significant and constructive comments and suggestions, which greatly improve the article.

Disclosures

The authors declare that no conflict of interest exists concerning this paper.

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Authors and Affiliations

  1. State Key Laboratory of Oncology in South China; Department of Medical Imaging and Interventional Radiology, Sun Yat-Sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, Guangdong, 510060, China

    Xiao-Fei Lv, Lu-Jun Han, Pei-Qiang Cai, Yao-Pan Wu, Zhen-Yin Liu, Pei-Hong Wu & Chuan-Miao Xie

  2. Department of Gastroenterology and Hepatology, Guangzhou First People’s Hospital, Guangzhou Medical University, No.1 Panfu Road, Guangzhou, Guangdong, 510180, China

    Min Ye

  3. Medical Imaging Centre, Nanfang Hospital, Southern Medial University, 1838 Guangzhou Ave North, Guangzhou, Guangdong, 510515, China

    Xue-Lin Zhang, Shi-Jun Qiu & Kai Liu

  4. Department of Medical Imaging, Guangdong No.2 Provincial People’s Hospital, No.1 Courtyard, Shiliugang Road, Haizhu District, Guangzhou, 510317, China

    Gui-Hua Jiang & Ying-Wei Qiu

Authors
  1. Xiao-Fei Lv
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  2. Min Ye
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  3. Lu-Jun Han
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  5. Pei-Qiang Cai
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  6. Gui-Hua Jiang
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  8. Shi-Jun Qiu
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  9. Yao-Pan Wu
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  10. Kai Liu
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  11. Zhen-Yin Liu
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  12. Pei-Hong Wu
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  13. Chuan-Miao Xie
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Corresponding authors

Correspondence to Pei-Hong Wu or Chuan-Miao Xie.

Additional information

Drs. Xiao-Fei Lv, Min Ye and Lu-Jun Han contributed to the work equally.

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Lv, XF., Ye, M., Han, LJ. et al. Abnormal baseline brain activity in patients with HBV-related cirrhosis without overt hepatic encephalopathy revealed by resting-state functional MRI. Metab Brain Dis 28, 485–492 (2013). https://doi.org/10.1007/s11011-013-9420-4

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  • DOI: https://doi.org/10.1007/s11011-013-9420-4

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