Abstract
Among all organs, the liver ranks first in both size and the variety of its functional accomplishments. Located between the intestine and systemic circulation, the liver is, in effect, both a filter and a metabolic factory. Through mechanisms regulated by the level of available energy substrate and the two hormones, insulin and glucagon, the liver is the organ that is responsible for determining whether ingested and absorbed nutrients in the form of chemical energy are to be either utilized immediately or to be stored for later use. The liver is also the primary site for the activation, storage, and release of several vitamins. It is additionally a major site of protein synthesis, glycogen synthesis and storage, and is the primary regulator of the plasma level of cholesterol and other fats. An additional important function performed by hepatocytes is the manufacture of bile, a unique biologic detergent containing, among many other components, bile salts and cholesterol. Thus the liver plays an integral role in maintaining the nutritional and metabolic well-being of the organism.
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References
Acker, W., Majumdar, S., Shaw, G., and Thomson, A. (1982). The relationship between brain and liver damage in chronic alcoholic patients. Journal of Neurology, Neurosurgery and Psychiatry, 45, 984–987.
Adams, R., and Foley, J. (1953). The neurological disorder associated with liver disease. In H. Merritt and C. Have (Eds.), Metabolic and toxic diseases of the nervous system (pp. 198–237 ). Baltimore: Williams and Wilkins.
Atkinson, M., and Goligher, J. (1960). Recurrent hepatic coma treated by colectomy and rheorectal anastomosis. Lancet, 1, 461–464.
Bernthal, P., Hays, A., Tarter, R., Lecky, J., Hedgedus, A., and Van Thiel, D. (1987). Cerebral CT scan abnormalities in cholestatic and hepatocellular disease and their relationship to psychometric indices of encephalopathy. Hepatology, 7, 107–114.
Berry, J., Owen, E., Flanagan, J., and Tyor, M. (1960). The effect of acute hyperventilation on the blood ammonia concentration of patients with liver disease. Journal of Laboratory and Clinical Medicine, 55, 849–854.
Bickford, R., and Butt, H. (1955). Hepatic coma: The EEG pattern. Journal of Clinical Investigation, 34, 790–799.
Chen, T., and Chen, P. (1977). Essential hepatology. Boston: Butterworth.
Conn, H., and Lieberthal, M. (1979). The hepatic coma syndrome and lactulose. Baltimore: Williams and Wilkins.
Conn, H., Leevy, C., Vahcevic, Z., Rodgers, J., Maddrey, W., Seeff, L., and Levy, L. (1977). Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial. Gastroenterology, 72, 573–583.
Davidson, P., Willoughby, R., O’Tuama, L., and Swisher, C. (1978). Neurological and intellectual sequelae of Reye’s Syndrome. American Journal of Mental Deficiency, 82, 535–541.
Dudrick, S., Mackie, J., and Serlin, O. (1968). Surgical exclusion of the colon for chronic hepatic encephalopathy. American Journal of Surgery, 115, 57–62.
Elsass, P., Lund, Y., and Ranek, L. (1978). Encephalopathy in patients with cirrhosis of the liver. A Neuropsychological study. Scandinavian Journal of Gastroenterology, 13, 241–247.
Fung, W., and Khoo, O. (1971). Lactulose in the treatment of acute and chronic hepatic encephalopathy. Singapore Medical Journal, 12, 176–180.
Galambos, J. (1979). Cirrhosis: Epidemiology. In L. Smith (Ed.), Major problems in internal medicine (pp. 261–276 ). Philadelphia: W. B. Saunders.
Geffray, Y., Segrestin, M., and Geffray, P. (1970). Interest du lactulose dans la traitement de l’encephalopathic portocave chronique-a propos de 20 observations. Therapeuteque, 46, 897–901.
Germain, L., Frezinos, J., Louis, A., and Ribet, A. (1973). Effect of lactulose on post-shunt hepatic encephalopathy: A controlled trial. Archive of Applied Digestive Diseases (French), 62, 293–301.
Gilberstadt, S., Gilberstadt, H., Zieve, L., Buegel, B., Collier, R., and McClain, C. (1980). Psychomotor performance deficits in cirrhotic patients without overt encephalopathy. Archives of Internal Medicine, 140, 519–521.
Gunderson, H., and Amidsen, A. (1969). The electrophoretic pattern of alkaline phosphatase in schizophrenic females under long-term treatment with neuroleptic drugs and in young and old healthy women. Scandinavian Journal of Clinical and Laboratory Investigation, 24, 173–177.
Havens, L., and Child, C. (1955). Recurrent psychosis associated with liver disease and elevated blood ammonia. New England Journal of Medicine, 252, 756–759.
Hegedus, A., Tarter, R., Van Thiel, D., Schade, R., Gavaler, J., and Starzl, T. (1984). Neuropsychiatric characteristics associated with primary biliary cirrhosis. The International Journal of Psychiatry in Medicine, 14, 303–313.
James, I., MacDonald, L., and Xanalatos, C. (1974). Effect of ammonium salts on brain metabolism. Journal of Neurology, Neurosurgery and Psychiatry, 37, 948–953.
Jefferson, J., and Marshall, J. (1981). Neuropsychiatric features of medical disorders. New York: Plenum Press.
Jervis, G. (1979). Encephalopathy in infantile hepatic cirrhosis. Acta Neuropathologica, 48, 273–275.
Kardel, T., and Stigsby, B. (1975). Period-amplitude analysis of the electroencephalogram correlated with liver function in patients with cirrhosis of the liver. Electroencephalography and Clinical Neurophysiology, 38, 605–609.
Laidlow, J., Read, A., and Sherlock, S. (1961). Morphine tolerance in hepatic cirrhosis. Gastroenterology, 40, 389–396.
Lee, K., Moller, L., Hardt, F., Haubek, A., and Jensen, E. (1979). Alcohol-induced brain damage and liver damage in young males. Lancet, 2, 759–761.
Leevy, C. (1974). Exploring the brain-liver relationship. Modern Medicine, 42, 17–22.
Lieber, C., and Leo, M. (1982). Alcohol and the liver. In C. Lieber (Ed.), Medical disorders of alcoholism: Pathogenesis and treatment (pp. 219–312 ). Philadelphia: W. B. Saunders.
Ma, M., McLeod, J., and Blackburn, C. (1969). Long-term treatment of portal-systemic encephalopathy with lactulose. Australian Annals of Medicine, 18, 117–123.
Martinez, A. (1968). Electron microscopy in human hepatic encephalopathy. Acta Neuropathologica, 11, 82–86.
McClain, C., Potter, T., Kromhout, J., and Zieve, L. (1984). The effect of lactulose on psychomotor performance tests in alcoholic cirrhotics without overt hepatic encephalopathy. Journal of Clinical Gastroenterology, 6, 325–329.
Morgan, M., and Read, A. (1972). Antidepressants and liver disease. Gut, 13, 697–701.
Parsons-Smith, B., Summerskill, W., Dawson, A., and Sherlock, S. (1957). The electroencephalograph in liver disease. Lancet, 2, 867–871.
Read, A., Laidlow, J., and McCarthy, C. (1969). Effects of chlorpromazine in patients with hepatic disease. British Medical Journal, 3, 497–499.
Rehnstrom, S., Simert, G., Hansson, J., Johnson, G., and Vang, J. (1977). Chronic hepatic encephalopathy. A psychometrical study. Scandinavian Journal of Gastroenterology, 12, 305–311.
Resnick, R., Ishihara, A., Chalmers, T., and Schimmel, E. (1968). The Boston interhospital liver group: A controlled trial of colon bypass in chronic hepatic encephalopathy. Gastroenterology, 54, 1057–1069.
Reynolds, T., Redeker, A., and Davis, P. (1958). A controlled study of the effects of L-arginine on hepatic encephalopathy. American Journal of Medicine, 25, 359–367.
Rikkers, L., Jenko, P., Rudman, D., and Freides, D. (1978). Subclinical hepatic encephalopathy: Detection, prevalence and relationship to nitrogen metabolism. Gastroenterology, 75, 462–469.
Rosselli, M., Lorenzana, P., and Rosselli, A. (1985). Wilson’s Disease: A case of reversible dementia. Journal of Clinical and Experimental Neuropsychology, 7, 616 (abstract).
Sandford, S., Sclabassi, R., Tarter, R., and Van Thiel, D. (1987). Sensory information processing in nonalcoholic cirrhosis: Visual, auditory, and somatosensory event-related potentials. Journal of the Neurological Sciences, 80, 269–276.
Schienberg, J., and Stemlieb, J. (1984). Wilson’s disease. Philadelphia: W. B. Saunders.
Schomerus, H., Hamster, W., Blunck, H., Reinhard, U., Mayer, K., and Dole, W. (1981). Latent portasystemic encephalopathy. 1. Nature of cerebral functional defects and their effect on fitness to drive. Digestive Diseases and Sciences, 28, 622–630.
Sherlock, S., Summerskill, W., White, L., and Pheur, E. (1954). Portal-systemic encephalopathy. Neurological complications of liver disease. Lancet, 2, 453–457.
Simmons, F., Goldstein, H., and Boyle, J. (1970). A controlled clinical trial of lactulose in hepatic encephalopathy. Gastroenterology, 59, 827–832.
Smith, J., and Smith, L. (1977). WAIS functioning of cirrhotic and noncirrhotic alcoholics. Journal of Clinical Psychology, 33, 309–313.
Summerskill, W., Davidson, E., Sherlock, S., and Steiner, R. (1956). The neuropsychiatric syndrome associated with hepatic cirrhosis and an extensive portal collateral circulation. Quarterly Journal of Medicine, 25, 245–266.
Tarter, R., and Edwards, K. (1985). Neuropsychology of alcoholism: In R. Tarter and D. Van Thiel (Eds.), Alcohol and the brain: Chronic effects (pp. 217–242 ). New York: Plenum Press.
Tarter, R., Hegedus, A., Van Thiel, D., Schade, R., Cavaler, J., and Starzl, T. (1984). Nonalcoholic cirrhosis associated with neuropsychological dysfunction in the absence of overt evidence of hepatic encephalopathy. Gastroenterology, 86, 1421–1427.
Tarter, R., Van Thiel, D., Hegedus, A., Schade, R., Cavaler, J., and Starzl, T. (1984). Liver transplantation: Long-term neuropsychiatric status. The Journal of Laboratory and Clinical Medicine, 103, 776–782.
Tarter, R., Hegedus, A., Van Thiel, D., Cavaler, J., and Schade, R. (1986). Hepatic dysfunction and neuropsychological test performance in alcoholics with cirrhosis. Journal of Studies on Alcohol, 47, 74–77.
Tarter, R., Hays, A., Sandford, S., Bernthal, P., and Van Thiel, D. (1986). Cerebral morphologic status is predicted by liver injury severity in patients with nonalcoholic cirrhosis. Lancet, 2, 893–895.
Tarter, R., Hegedus, A., Van Thiel, D., Edwards, N., and Schade, R. (1987). Neurobehavioral correlates of cholestatic and hepatocellular disease: Differentiation according to disease specific characteristics and severity of the identified cerebral dysfunction. International Journal of Neuroscience, 32, 901–910.
Tarter, R., Sclabassi, R., Sandford, S., Hays, A., Carra, J., and Van Thiel, D. (1987). Relationship between hepatic injury status and event related potentials. Clinical Electroencephalography, 18, 15–19.
Tarter, R., Switala, J., Carra, J., Edwards, N., and Van Thiel, D. (1987). Neuropsychologic impairment in patients with Wilson’s Disease who do not exhibit overt encephalopathy. International Journal of Neuroscience.
Tarter, R., Hays, A., Switala, J., and Van Thiel, D. (1987). The influence of Sjogren’s Syndrome on the manifest neuropsychiatric disturbances concomitant to primary hiliary cirrhosis. Unpublished manuscript.
Victor, M., Adams, R., and Cole, M. (1965). The acquired non-Wilsonian type of chronic hepatocerebral degeneration. Medicine, 44, 345–396.
Yang, S., and Chu, Y. (1985). Somatosensory evoked potentials in hepatic encephalopathy. Gastroenterology, 89, 625–630.
Zeegen, R., Drinkwater, J., and Dawson, A. (1970). Method for measuring cerebral dysfunction in patients with liver disease. British Medical Journal, 2, 633–636.
Zeneroli, M., Pinelli, G., Gollini, G., Penna, A., Messori, E., Zani, G., and Ventura, E. (1984). Visual evoked potentials: A diagnostic tool for the assessment of hepatic encephalopathy. Gut, 25, 291–299.
Zieve, L. (1979). Hepatic encephalopathy: Summary of present knowledge with an elaboration on recent developments. In H. Popper and F. Schaffner (Eds.), Progress in liver diseases (pp. 88–104 ). New York: Grune and Stratton.
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Tarter, R.E., Edwards, K.L., Van Thiel, D.H. (1988). Neuropsychological Dysfunction Due to Liver Disease. In: Tarter, R.E., Van Thiel, D.H., Edwards, K.L. (eds) Medical Neuropsychology. Critical Issues in Neuropsychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1165-3_4
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