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KMID : 1100220040030010042
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Dementia and Neurocognitive Disorders
2004 Volume.3 No. 1 p.42 ~ p.47
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Neuropsychological Test for the Detection of Minimal Hepatic Encephalopathy
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Yang Dong-Won
Shon Young-Min
Kim Beum-Saeng
Han Joon-Yeol
Chung Kyu-Won
Sun Hee-Sik
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Abstract
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Background and Objectives: Minimal hepatic encephalopathy (MHE) is assumed to have a negative effect on patient´s daily functioning but is difficult with standard clinical examination. This study is designed to elucidate the characteristics of neuropsychological deficits associated with MHE in patients with liver cirrhosis.
Methods: We studied 27 patients with clinically proven liver cirrhosis, without climical signs of encephalopathy and 30 healthy controls without liver disease. Neuropsychological tests employed to detect MHE were auditory verbal learning test (AVLT) of Rey-Kim memory test, trail making test A, B (TMT-A, TMT-B), digit symbol test(DST), digit span test forward and backward(DST-F, DST-B) word fluency test-category (WFT-C), word fluency test-letter (WFT-L), block design test of Wechsler Adult Intelligence Scale-Revised, and Korean version of Boston naming test and pin insertion test (PIT). Korean version of Mini-Mental state Examination (K-MMSE) was also performed in order to evaluate general cognitive functions.
Results: Among the neuropsychological tests applied, TMT-A, TMT-B, DST-F, WFT-C, WFT-L, DST and PIT appeared to be significantly different between liver cirrhosis and control group. Patients who had two or more abnormal test results (over or below the mean±2 S.D of the control) were considered to have MHE. Seven patients (25.9%) with liver cirrhosis and 1 (3.3%) subject were cinsidered abnormal on the basis of this criteria.
Conclusion: The cirrhotic patients shown relatively selective deficits in complex attention, fine motor skill and psychomotor speed, while general intelligence memory, language and visuospatial functions were spared. Follow-up the patients with MHE is necessary to clarity the clinical significance and the diagnosis of the MHE based on the neuropsychological tests.
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KEYWORD
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Minimal hepatic encephalopathy, Neuropsychological tests, Liver cirrhosis, Subclinical hepatic encephalopathy
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