Recent developments in the diagnosis and treatment of covert/minimal hepatic encephalopathy

References

• Poordad FF. Review article: the burden of hepatic encephalopathy. Aliment Pharmacol Ther. 2007;25(Suppl 1):3–9.
   PubMed Web of Science ®Google Scholar
• Stepanova M, Mishra A, Venkatesan C, et al. In-hospital mortality and economic burden associated with hepatic encephalopathy in the United States from 2005 to 2009. Clin Gastroenterol Hepatol. 2012;10:1034–1041.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Cordoba J, Mullen KD, et al. Review article: the design of clinical trials in hepatic encephalopathy–an international society for hepatic encephalopathy and nitrogen metabolism (ISHEN) consensus statement. Aliment Pharmacol Ther. 2011;33:739–747.
   PubMed Web of Science ®Google Scholar
• Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American association for the study of liver diseases and the European association for the study of the liver. Hepatology. 2014;60:715–735.
   PubMed Web of Science ®Google Scholar
• Conn HO, Leevy CM, Vlahcevic ZR, et al. Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial. Gastroenterology. 1977;72:573–583.
   PubMed Web of Science ®Google Scholar
• Amodio P, Pellegrini A, Ubiali E, et al. The EEG assessment of low-grade hepatic encephalopathy: comparison of an artificial neural network-expert system (ANNES) based evaluation with visual EEG readings and EEG spectral analysis. Clin Neurophysiol. 2006;117:2243–2251.
   PubMed Web of Science ®Google Scholar
• Romero-Gomez M, Cordoba J, Jover R, et al. Value of the critical flicker frequency in patients with minimal hepatic encephalopathy. Hepatology. 2007;45:879–885.
   PubMed Web of Science ®Google Scholar
• Saxena N, Bhatia M, Joshi YK, et al. Electrophysiological and neuropsychological tests for the diagnosis of subclinical hepatic encephalopathy and prediction of overt encephalopathy. Liver. 2002;22:190–197.
   PubMedGoogle Scholar
• Montagnese S, De RM, Schiff S, et al. Prognostic benefit of the addition of a quantitative index of hepatic encephalopathy to the MELD score: the MELD-EEG. Liver Int. 2015;35:58–64.
   PubMed Web of Science ®Google Scholar
• Kircheis G, Knoche A, Hilger N, et al. Hepatic encephalopathy and fitness to drive. Gastroenterology. 2009;137:1706–1715.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Saeian K, Schubert CM, et al. Minimal hepatic encephalopathy is associated with motor vehicle crashes: the reality beyond the driving test. Hepatology. 2009;50:1175–1183.
   PubMed Web of Science ®Google Scholar
• Montagnese S, Amato E, Schiff S, et al. A patients’ and caregivers’ perspective on hepatic encephalopathy. Metab Brain Dis. 2012;27:567–572.
   PubMed Web of Science ®Google Scholar
• Prasad S, Dhiman RK, Duseja A, et al. Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy. Hepatology. 2007;45:549–559.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Riggio O, Allampati S, et al. Cognitive dysfunction is associated with poor socioeconomic status in patients with cirrhosis: an international multicenter study. Clin Gastroenterol Hepatol. 2013;11:1511–1516.
   PubMed Web of Science ®Google Scholar
• Amodio P, Montagnese S, Gatta A, et al. Characteristics of minimal hepatic encephalopathy. Metab Brain Dis. 2004;19:253–267.
   PubMed Web of Science ®Google Scholar
• Montagnese S, Cona G, Schiff S, et al. The hunter and the pianist: two hepatic encephalopathy tales. J Clin Gastroenterol. 2011;45:563–566.
   PubMed Web of Science ®Google Scholar
• Amodio P, Valenti P, Del PF, et al. P300 latency for the diagnosis of minimal hepatic encephalopathy: evidence that spectral EEG analysis and psychometric tests are enough. Dig Liver Dis. 2005;37:861–868.
   PubMedGoogle Scholar
• Amodio P, Campagna F, Olianas S, et al. Detection of minimal hepatic encephalopathy: normalization and optimization of the psychometric hepatic encephalopathy score. A neuropsychological and quantified EEG study. J Hepatol. 2008;49:346–353.
   PubMed Web of Science ®Google Scholar
• Dhiman RK, Kurmi R, Thumburu KK, et al. Diagnosis and prognostic significance of minimal hepatic encephalopathy in patients with cirrhosis of liver. Dig Dis Sci. 2010;55:2381–2390.
   PubMed Web of Science ®Google Scholar
• Goldbecker A, Weissenborn K, Hamidi SG, et al. Comparison of the most favoured methods for the diagnosis of hepatic encephalopathy in liver transplantation candidates. Gut. 2013;62:1497–1504.
   PubMed Web of Science ®Google Scholar
• Kircheis G, Hilger N, Haussinger D. Value of critical flicker frequency and psychometric hepatic encephalopathy score in diagnosis of low-grade hepatic encephalopathy. Gastroenterology. 2014;146:961–969.
   PubMed Web of Science ®Google Scholar
• Elsass P, Christensen SE, Mortensen EL, et al. Discrimination between organic and hepatic encephalopathy by means of continuous reaction times. Liver. 1985;5:29–34.
   PubMedGoogle Scholar
• Lauridsen MM, Schaffalitzky De Muckadell OB, Vilstrup H. Minimal hepatic encephalopathy characterized by parallel use of the continuous reaction time and portosystemic encephalopathy tests. Metab Brain Dis. 2015;30:1187–1192.
   PubMed Web of Science ®Google Scholar
• Amodio P, Ridola L, Schiff S, et al. Improving the inhibitory control task to detect minimal hepatic encephalopathy. Gastroenterology. 2010;139(510–8):518.
   Google Scholar
• Bajaj JS, Saeian K, Verber MD, et al. Inhibitory control test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy. Am J Gastroenterol. 2007;102:754–760.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Thacker LR, Heuman DM, et al. The Stroop smartphone application is a short and valid method to screen for minimal hepatic encephalopathy. Hepatology. 2013;58:1122–1132.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Heuman DM, Sterling RK, et al. Validation of EncephalApp, smartphone-based Stroop test, for the diagnosis of covert hepatic encephalopathy. Clin Gastroenterol Hepatol. 2015;13:1828–1835.
   PubMed Web of Science ®Google Scholar
• Amodio P, Cordoba J. Smart applications for assessing minimal hepatic encephalopathy: novelty from the app revolution. Hepatology. 2013;58:844–846.
   PubMed Web of Science ®Google Scholar
• Amodio P, Marchetti P, Del PF, et al. Study on the sternberg paradigm in cirrhotic patients without overt hepatic encephalopathy. Metab Brain Dis. 1998;13:159–172.
   PubMed Web of Science ®Google Scholar
• Amodio P, Del PF, Marchetti P, et al. Clinical features and survivial of cirrhotic patients with subclinical cognitive alterations detected by the number connection test and computerized psychometric tests. Hepatology. 1999;29:1662–1667.
   PubMed Web of Science ®Google Scholar
• Montagnese S, Schiff S, Turco M, et al. Simple tools for complex syndromes: a three-level difficulty test for hepatic encephalopathy. Dig Liver Dis. 2012;44:957–960.
   PubMedGoogle Scholar
• Amodio P, Del PF, Petteno E, et al. Prevalence and prognostic value of quantified electroencephalogram (EEG) alterations in cirrhotic patients. J Hepatol. 2001;35:37–45.
   PubMed Web of Science ®Google Scholar
• Morgan MY, Amodio P, Cook NA, et al. Qualifying and quantifying minimal hepatic encephalopathy. Metab Brain Dis. 2015. [Epub ahead of print]. doi:10.1007/s11011-015-9726-5
   Google Scholar
• Zhang LJ, Yang G, Yin J, et al. Neural mechanism of cognitive control impairment in patients with hepatic cirrhosis: a functional magnetic resonance imaging study. Acta Radiol. 2007;48:577–587.
   PubMed Web of Science ®Google Scholar
• Koziarska D, Wunsch E, Milkiewicz M, et al. Mini-mental state examination in patients with hepatic encephalopathy and liver cirrhosis: a prospective, quantified electroencephalography study. BMC Gastroenterol. 2013;13:107.
   PubMed Web of Science ®Google Scholar
• Corrias M, Turco M, Rui MD, et al. Covert hepatic encephalopathy: does the mini-mental state examination help? J Clin Exp Hepatol. 2014;4:89–93.
   PubMedGoogle Scholar
• Malaguarnera M, Gargante MP, Malaguarnera G, et al. Bifidobacterium combined with fructo-oligosaccharide versus lactulose in the treatment of patients with hepatic encephalopathy. Eur J Gastroenterol Hepatol. 2010;22:199–206.
   PubMed Web of Science ®Google Scholar
• Malaguarnera M, Vacante M, Giordano M, et al. Oral acetyl-L-carnitine therapy reduces fatigue in overt hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr. 2011;93:799–808.
   PubMed Web of Science ®Google Scholar
• Watanabe A, Sakai T, Sato S, et al. Clinical efficacy of lactulose in cirrhotic patients with and without subclinical hepatic encephalopathy. Hepatology. 1997;26:1410–1414.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Saeian K, Christensen KM, et al. Probiotic yogurt for the treatment of minimal hepatic encephalopathy. Am J Gastroenterol. 2008;103:1707–1715.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Heuman DM, Wade JB, et al. Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy. Gastroenterology. 2011;140:478–487.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Pinkerton SD, Sanyal AJ, et al. Diagnosis and treatment of minimal hepatic encephalopathy to prevent motor vehicle accidents: a cost-effectiveness analysis. Hepatology. 2012;55: 1164–1171.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Heuman DM, Hylemon PB, et al. Randomised clinical trial: lactobacillus GG modulates gut microbiome, metabolome and endotoxemia in patients with cirrhosis. Aliment Pharmacol Ther. 2014;39:1113–1125.
   PubMed Web of Science ®Google Scholar
• Burkard T, Biedermann A, Herold C, et al. Treatment with a potassium-iron-phosphate-citrate complex improves PSE scores and quality of life in patients with minimal hepatic encephalopathy: a multicenter, randomized, placebo-controlled, double-blind clinical trial. Eur J Gastroenterol Hepatol. 2013;25:352–358.
   PubMed Web of Science ®Google Scholar
• Dhiman RK, Sawhney MS, Chawla YK, et al. Efficacy of lactulose in cirrhotic patients with subclinical hepatic encephalopathy. Dig Dis Sci. 2000;45:1549–1552.
   PubMed Web of Science ®Google Scholar
• Horsmans Y, Solbreux PM, Daenens C, et al. Lactulose improves psychometric testing in cirrhotic patients with subclinical encephalopathy. Aliment Pharmacol Ther. 1997;11:165–170.
   PubMed Web of Science ®Google Scholar
• Liu Q, Duan ZP, Ha DK, et al. Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology. 2004;39:1441–1449.
   PubMed Web of Science ®Google Scholar
• Malaguarnera M, Greco F, Barone G, et al. Bifidobacterium longum with fructo-oligosaccharide (FOS) treatment in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Dig Dis Sci. 2007;52:3259–3265.
   PubMed Web of Science ®Google Scholar
• Mittal VV, Sharma BC, Sharma P, et al. A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy. Eur J Gastroenterol Hepatol. 2011;23:725–732.
   PubMed Web of Science ®Google Scholar
• Nie Y-Q, Zeng Z, Li -Y-Y, et al. [Long-term efficacy of lactulose in patients with subclinical hepatic encephalopathy]. Zhonghua Nei Ke Za Zhi. 2003;42:261–263.
   PubMedGoogle Scholar
• Plauth M, Egberts EH, Hamster W, et al. Long-term treatment of latent portosystemic encephalopathy with branched-chain amino acids. A double-blind placebo-controlled crossover study. J Hepatol. 1993;17:308–314.
   PubMed Web of Science ®Google Scholar
• Pratap MV, Benjamin J, Bhushan SM, et al. Effect of probiotic VSL#3 in the treatment of minimal hepatic encephalopathy: A non-inferiority randomized controlled trial. Hepatol Res. 2015;45: 880–889.
   PubMed Web of Science ®Google Scholar
• Rai R, Ahuja CK, Agrawal S, et al. Reversal of low-grade cerebral Edema after Lactulose/Rifaximin therapy in patients with cirrhosis and minimal hepatic encephalopathy. Clin Transl Gastroenterol. 2015;6:e111.
   PubMedGoogle Scholar
• Sharma P, Sharma BC, Puri V, et al. An open-label randomized controlled trial of lactulose and probiotics in the treatment of minimal hepatic encephalopathy. Eur J Gastroenterol Hepatol. 2008;20:506–511.
   PubMed Web of Science ®Google Scholar
• Sharma P, Sharma BC, Agrawal A, et al. Primary prophylaxis of overt hepatic encephalopathy in patients with cirrhosis: an open labeled randomized controlled trial of lactulose versus no lactulose. J Gastroenterol Hepatol. 2012;27:1329–1335.
   PubMed Web of Science ®Google Scholar
• Sidhu SS, Goyal O, Mishra BP, et al. Rifaximin improves psychometric performance and health-related quality of life in patients with minimal hepatic encephalopathy (the RIME Trial). Am J Gastroenterol. 2011;106:307–316.
   PubMed Web of Science ®Google Scholar
• Sidhu SS, Goyal O, Parker RA, et al. Rifaximin vs. lactulose in treatment of minimal hepatic encephalopathy. Liver Int. 2015. [Epub ahead of print]. doi:10.1111/liv.12921.
   PubMed Web of Science ®Google Scholar
• Zeng Z, Li -Y-Y. [Effects of lactulose treatment on the course of subclinical hepatic encephalopathy]. Zhonghua Yi Xue Za Zhi. 2003;83:1126–1129.
   PubMedGoogle Scholar
• Zhang Y, Feng Y, Cao B, et al. Effects of SIBO and rifaximin therapy on MHE caused by hepatic cirrhosis. Int J Clin Exp Med. 2015;8:2954–2957.
   PubMed Web of Science ®Google Scholar
• Ziada DH, Soliman HH, El Yamany SA, et al. Can Lactobacillus acidophilus improve minimal hepatic encephalopathy? A neurometabolite study using magnetic resonance spectroscopy. Arab J Gastroenterol. 2013;14:116–122.
   PubMedGoogle Scholar
• Luo M, Li L, Lu C-Z, et al. Clinical efficacy and safety of lactulose for minimal hepatic encephalopathy: a meta-analysis. Eur J Gastroenterol Hepatol. 2011;23:1250–1257.
   PubMed Web of Science ®Google Scholar
• Shukla S, Shukla A, Mehboob S, et al. Meta-analysis: the effects of gut flora modulation using prebiotics, probiotics and synbiotics on minimal hepatic encephalopathy. Aliment Pharmacol Ther. 2011;33:662–671.
   PubMed Web of Science ®Google Scholar
• Amodio P, Bemeur C, Butterworth R, et al. The nutritional management of hepatic encephalopathy in patients with cirrhosis: international society for hepatic encephalopathy and nitrogen metabolism consensus. Hepatology. 2013;58:325–336.
   PubMed Web of Science ®Google Scholar
• Amodio P, Canesso F, Montagnese S. Dietary management of hepatic encephalopathy revisited. Curr Opin Clin Nutr Metab Care. 2014;17:448–452.
   PubMed Web of Science ®Google Scholar
• Amodio P. Hepatic encephalopathy. In: Lee SS, Moreau R, editors. Cirrhosis: A practical guide to management. Hoboken, NJ: John Wiley & Sons; 2015. p. 105–123.
   Google Scholar