Journal ArticleDOI
Hepatic encephalopathy: effects of liver failure on brain function
Reads0
Chats0
TLDR
The latest studies aimed at understanding how liver failure affects brain function and potential ways to ameliorate these effects are reviewed.Abstract:
Liver failure affects brain function, leading to neurological and psychiatric alterations; such alterations are referred to as hepatic encephalopathy (HE). Early diagnosis of minimal HE reveals an unexpectedly high incidence of mild cognitive impairment and psychomotor slowing in patients with liver cirrhosis - conditions that have serious health, social and economic consequences. The mechanisms responsible for the neurological alterations in HE are beginning to emerge. New therapeutic strategies acting on specific targets in the brain (phosphodiesterase 5, type A GABA receptors, cyclooxygenase and mitogen-activated protein kinase p38) have been shown to restore cognitive and motor function in animal models of chronic HE, and NMDA receptor antagonists have been shown to increase survival in acute liver failure. This article reviews the latest studies aimed at understanding how liver failure affects brain function and potential ways to ameliorate these effects.read more
Citations
More filters
Journal ArticleDOI
Molecular and Functional Neuroscience in Immunity.
TL;DR: The anatomical and molecular basis of the neural interface with immunity is reviewed, focusing on peripheral neural control of immune functions and the role of the brain in the model of the immunological homunculus.
Journal ArticleDOI
Neural circuitry and immunity
TL;DR: These findings and current clinical exploration of neuromodulation in the treatment of inflammatory diseases define the emerging field of Bioelectronic Medicine.
Journal ArticleDOI
Hepatic encephalopathy in patients with acute decompensation of cirrhosis and acute on chronic liver failure
TL;DR: Hepatic encephalopathy in patients with ACLF appears to be clinically and pathophysiologically distinct from that of acute decompensation and requires further studies and characterization.
Journal ArticleDOI
Astrogliopathology in neurological, neurodevelopmental and psychiatric disorders
TL;DR: Astroglia contribute to neurodegenerative processes seen in amyotrophic lateral sclerosis, Alzheimer's and Huntington's diseases, and play a role in major neuropsychiatric disorders, ranging from schizophrenia to depression, as well as in addictive disorders.
Journal ArticleDOI
Treating the whole body in Huntington's disease
TL;DR: Treatments targeted to tissues and organs outside the CNS might substantially improve the quality of life of patients with Huntington's disease, even in the absence of disease-modifying effects.
References
More filters
Journal ArticleDOI
Hepatic encephalopathy—Definition, nomenclature, diagnosis, and quantification: Final report of the Working Party at the 11th World Congresses of Gastroenterology, Vienna, 1998
Peter Ferenci,Alan H. Lockwood,Kevin D. Mullen,Ralph E. Tarter,Karin Weissenborn,Andres T. Blei +5 more
TL;DR: The Working Party felt the need for a large study to redefine neuropsychiatric abnormalities in liver disease, which would allow the diagnosis of minimal (subclinical) encephalopathy to be made on firm statistical grounds, and suggested a modification of current nomenclature for clinical diagnosis of hepaticEncephalopathy.
Journal ArticleDOI
Rifaximin treatment in hepatic encephalopathy.
Nathan M. Bass,Kevin D. Mullen,Arun J. Sanyal,Fred Poordad,Guy W. Neff,Carroll B. Leevy,Samuel H. Sigal,Muhammad Y. Sheikh,Kimberly Beavers,Todd Frederick,Lewis W. Teperman,Donald J. Hillebrand,Shirley Huang,Kunal Merchant,Audrey L. Shaw,Enoch Bortey,William P. Forbes +16 more
TL;DR: Over a 6-month period, treatment with rifaximin maintained remission from hepatic encephalopathy more effectively than did placebo, and also significantly reduced the risk of hospitalization involving hepaticEncephalopathy.
Journal ArticleDOI
Comparison of Lactulose and Neomycin in the Treatment of Chronic Portal-Systemic Encephalopathy: A double blind controlled trial
TL;DR: These investigations demonstrate that both lactulose and neomycin-sorbitol are effective in the treatment of chronic portal-systemic encephalopathy.
Journal ArticleDOI
Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema?
TL;DR: Clearly, pathogenetic models have to explain the functional nature and reversibility of HE symptoms, and their precipitation by heterogeneous factors, such as infections, diuretics, sedatives, trauma, bleeding or high protein intake.
Journal ArticleDOI
Systemic inflammatory response exacerbates the neuropsychological effects of induced hyperammonemia in cirrhosis
TL;DR: The significant deterioration of neuropsychological test scores following induced hyperammonemia during the inflammatory state, but not after its resolution, suggests that the inflammation and its mediators may be important in modulating the cerebral effect of ammonia in liver disease.