Evaluation of cognitive impairment in patients with minimal hepatic encephalopathy based on degree centrality of fMRI postprint

Abstract: Background Minimal hepatic encephalopathy (MHE), as a special type of hepatic encephalopathy (HE), has atypical clinical symptoms but mild neurological and psychiatric deficits that are easily overlooked by patients and their families. However, the neurobiological mechanisms behind these deficits are still not fully understood. Objective To explore the abnormal patterns of brain functional networks in minimal hepatic encephalopathy (MHE) by using Degree Centrality (DC) method of resting state functional magnetic resonance imaging. To further elucidate the neuroimaging mechanisms of MHE. Materials and Methods: Twenty-eight prospective patients with hepatitis B cirrhosis with MHE (MHE group), 30 patients with simple hepatitis B cirrhosis (cirrhosis group) and 34 healthy volunteers (healthy control group) were enrolled and underwent conventional MRI and BOLD-fMRI were performed. Compare the difference of the whole brain DC values among the three groups, and use Person correlation analysis to evaluate the correlation between the brain DC values of MHE patients and their cognitive scales. Results: Compared with the control and cirrhosis groups, the cognitive scores of MHE group were significantly decreased (P< 0.05). Compared with the healthy control group, the brain regions with decreased DC values in the MHE group, including the right precentral gyrus, the right middle occipital gyrus and the left angular gyrus; increased DC values in the right middle frontal gyrus, the right inferior parietal lobule and the left middle temporal gyrus, with statistically difference (P< 0.05). Correlation analysis showed that in the MHE group, the DST score positively correlate with DC values in the left superior temporal gyrus, and negatively correlate with DC values in the right inferior temporal gyrus (All P<0.05), and the MoCA score were positively correlated with DC value of the bilateral inferior frontal gyrus (P<0.05), and were negatively correlated with DC value of the left middle temporal gyrus (P<0.05). Conclusions: This study has further confirmed that the brain network connectivity properties of MHE patients are abnormal, and the DC value may be a useful indicator to quantify MHE-related pathophysiological changes as well as a potential neuroimaging marker of MHE cognitive impairment.