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Hepatic Encephalopathy Linked to Chronic Cognitive Effects

Last Updated: June 18, 2010.

Among patients with cirrhosis, episodes of overt hepatic encephalopathy may be associated with lingering and cumulative problems with learning, working memory, and response inhibition, according to research published in the June issue of Gastroenterology.

FRIDAY, June 18 (HealthDay News) -- Among patients with cirrhosis, episodes of overt hepatic encephalopathy (OHE) may be associated with lingering and cumulative problems with learning, working memory, and response inhibition, according to research published in the June issue of Gastroenterology.

Jasmohan S. Bajaj, M.D., of the Virginia Commonwealth University in Richmond, and colleagues analyzed data from a cross-sectional arm with 226 patients with hepatic cirrhosis, with or without history of OHE; a cross-sectional arm with 50 patients with cirrhosis and a history of OHE; and a prospective arm with 59 cirrhotic patients without prior OHE at entry. Patients underwent testing of cognitive function.

The researchers found that patients with a history of OHE had more severe cognitive impairment, with severity increasing with the number of previous episodes of OHE. In those followed prospectively, a single episode of OHE was associated with a new defect in learning of response inhibition, and multiple OHE episodes were linked to defects in reaction time, set shifting, divided attention, response inhibition, and working memory, the authors write.

"In conclusion, this study demonstrates that there are residual effects on cognitive function, especially executive functions, that result in learning impairment and working memory problems in patients with OHE, even after their first episode despite adequate therapy and the attainment of normal mental status. This psychometric performance deterioration continues and expands to the more basic cognitive domains of psychomotor speed, set shifting, and divided attention with increasing numbers of episodes and hospitalizations for OHE," the authors conclude.

Two co-authors disclosed financial relationships with Salix and/or Ocera.

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