Changes in early visual perception in patients with minimal hepatic encephalopathy

Introduction and Objective: Minimal Hepatic Encephalopathy (MHE) is characterized by very subtle cognitive changes that are diagnosed with the Psychometric hepatic encephalopathy score (PHES) and critical flickering frequency (CFF). Patients with MHE are slower in attention tests evaluated with visu...

Full description

Bibliographic Details
Main Authors: D Montemira-Orozco, CI Hinojosa-Segura, A Burak-Leipuner, J Zavala-Ramírez, IG Cruz-Reyes, M Escobedo-Silva, F Higuera-de la Tijera, JL Pérez-Hernández, D Santana-Vargas
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Annals of Hepatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1665268122001284
_version_ 1828097662553948160
author D Montemira-Orozco
CI Hinojosa-Segura
A Burak-Leipuner
J Zavala-Ramírez
IG Cruz-Reyes
M Escobedo-Silva
F Higuera-de la Tijera
JL Pérez-Hernández
D Santana-Vargas
author_facet D Montemira-Orozco
CI Hinojosa-Segura
A Burak-Leipuner
J Zavala-Ramírez
IG Cruz-Reyes
M Escobedo-Silva
F Higuera-de la Tijera
JL Pérez-Hernández
D Santana-Vargas
author_sort D Montemira-Orozco
collection DOAJ
description Introduction and Objective: Minimal Hepatic Encephalopathy (MHE) is characterized by very subtle cognitive changes that are diagnosed with the Psychometric hepatic encephalopathy score (PHES) and critical flickering frequency (CFF). Patients with MHE are slower in attention tests evaluated with visual cognitive evocative potentials, which are late indicators. However, it is unknown whether there is also slowness in automatic responses of early visual perception, such as those of stationary visual potential P100. This study aimed to detect early visible changes in patients with minimal hepatic encephalopathy. Materials and Methods: Cirrhotic patients who went to the Liver Clinic of the Gastroenterology Service of the General Hospital of Mexico ''Eduardo Liceaga'' were included. The PHES, CFF test was applied and the electroencephalogram (EEG) was recorded while repeated visual stimuli were presented to obtain the stationary visual potential P100. The trial was approved by the research ethics committee, and informed consent was obtained. Results: Eighty-nine patients with hepatic cirrhosis participated, 54 women (60.7%) with 53 ± 7.9 years of age and 8.3 ± 3.4 years of schooling. 57 patients (64.0%) and 64 FCP-positive (71.9%) were PHES-positive. MHE (PHES and CFF positive) was detected in 53 patients (59.6%). 29 MHE patients and 10 patients with cirrhosis agreed to do the perceptual tests. P100 latency of the visual potential was quantified lower in patients with MHD 113 ± 9 milliseconds than in cirrhotic 94 ± 14 milliseconds. Conclusions: Patients with MHE showed slowness in early perceptual processes that preceded cognitive processes. Funding: Donation by the volunteer ladies of the Hospital General de México “Dr. Eduardo Liceaga.” Declaration of interest: The authors declare no potential conflicts of interest.
first_indexed 2024-04-11T07:49:31Z
format Article
id doaj.art-74f8e15121fa4b55b7317713a4ec1110
institution Directory Open Access Journal
issn 1665-2681
language English
last_indexed 2024-04-11T07:49:31Z
publishDate 2022-12-01
publisher Elsevier
record_format Article
series Annals of Hepatology
spelling doaj.art-74f8e15121fa4b55b7317713a4ec11102022-12-22T04:36:08ZengElsevierAnnals of Hepatology1665-26812022-12-0127100786Changes in early visual perception in patients with minimal hepatic encephalopathyD Montemira-Orozco0CI Hinojosa-Segura1A Burak-Leipuner2J Zavala-Ramírez3IG Cruz-Reyes4M Escobedo-Silva5F Higuera-de la Tijera6JL Pérez-Hernández7D Santana-Vargas8Department of Gastroenterology and Hepatology. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoDepartment of Gastroenterology and Hepatology. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoDepartment of Gastroenterology and Hepatology. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoResearch Department. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoResearch Department. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoDepartment of Gastroenterology and Hepatology. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoDepartment of Gastroenterology and Hepatology. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoDepartment of Gastroenterology and Hepatology. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, MexicoResearch Department. General Hospital of Mexico “Dr. Eduardo Liceaga.” Mexico City, Mexico; Sleep Disorders Clinic. Department of Experimental Medicine. Faculty of Medicine. UNAM. Mexico City, MexicoIntroduction and Objective: Minimal Hepatic Encephalopathy (MHE) is characterized by very subtle cognitive changes that are diagnosed with the Psychometric hepatic encephalopathy score (PHES) and critical flickering frequency (CFF). Patients with MHE are slower in attention tests evaluated with visual cognitive evocative potentials, which are late indicators. However, it is unknown whether there is also slowness in automatic responses of early visual perception, such as those of stationary visual potential P100. This study aimed to detect early visible changes in patients with minimal hepatic encephalopathy. Materials and Methods: Cirrhotic patients who went to the Liver Clinic of the Gastroenterology Service of the General Hospital of Mexico ''Eduardo Liceaga'' were included. The PHES, CFF test was applied and the electroencephalogram (EEG) was recorded while repeated visual stimuli were presented to obtain the stationary visual potential P100. The trial was approved by the research ethics committee, and informed consent was obtained. Results: Eighty-nine patients with hepatic cirrhosis participated, 54 women (60.7%) with 53 ± 7.9 years of age and 8.3 ± 3.4 years of schooling. 57 patients (64.0%) and 64 FCP-positive (71.9%) were PHES-positive. MHE (PHES and CFF positive) was detected in 53 patients (59.6%). 29 MHE patients and 10 patients with cirrhosis agreed to do the perceptual tests. P100 latency of the visual potential was quantified lower in patients with MHD 113 ± 9 milliseconds than in cirrhotic 94 ± 14 milliseconds. Conclusions: Patients with MHE showed slowness in early perceptual processes that preceded cognitive processes. Funding: Donation by the volunteer ladies of the Hospital General de México “Dr. Eduardo Liceaga.” Declaration of interest: The authors declare no potential conflicts of interest.http://www.sciencedirect.com/science/article/pii/S1665268122001284
spellingShingle D Montemira-Orozco
CI Hinojosa-Segura
A Burak-Leipuner
J Zavala-Ramírez
IG Cruz-Reyes
M Escobedo-Silva
F Higuera-de la Tijera
JL Pérez-Hernández
D Santana-Vargas
Changes in early visual perception in patients with minimal hepatic encephalopathy
Annals of Hepatology
title Changes in early visual perception in patients with minimal hepatic encephalopathy
title_full Changes in early visual perception in patients with minimal hepatic encephalopathy
title_fullStr Changes in early visual perception in patients with minimal hepatic encephalopathy
title_full_unstemmed Changes in early visual perception in patients with minimal hepatic encephalopathy
title_short Changes in early visual perception in patients with minimal hepatic encephalopathy
title_sort changes in early visual perception in patients with minimal hepatic encephalopathy
url http://www.sciencedirect.com/science/article/pii/S1665268122001284
work_keys_str_mv AT dmontemiraorozco changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT cihinojosasegura changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT aburakleipuner changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT jzavalaramirez changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT igcruzreyes changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT mescobedosilva changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT fhigueradelatijera changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT jlperezhernandez changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy
AT dsantanavargas changesinearlyvisualperceptioninpatientswithminimalhepaticencephalopathy