Cirrhosis, Hepatic Encephalopathy, Hepatitis C, Nonalcoholic Steatohepatitis
Conditions
Brief summary
Investigating the impact of hepatic encephalopathy on default mode networks within the brain to provide more clues with understanding the physiology of consciousness and predicting the reversibility of comatose states.
Detailed description
The proposed study will provide better understanding of the patterns of default mode network (DMN) dysfunction in comatose state of hepatic encephalopathy, may help to further define the boundaries of neuronal circuits involve, and will try to assess the prognostic value of fMRI in reversibility of severe metabolic coma.
Interventions
None listed
Sponsors
OSF Healthcare System
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
(Hepatic Encephalopathy Group) Inclusion Criteria: * Patient or legally acceptable representative must understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local patient privacy regulations. * Age 18 or older at the time of informed consent. * Patients with liver cirrhosis attending the gastroenterology department (inpatient or outpatient) with hepatic encephalopathy from various causes of liver failure (i.e. alcoholic, infectious, carcinomatous or toxic). * The patients will be selected applying Child Pughs score and West Raven classification for hepatic encephalopathy. * All patients participating in the study will undergo a full neurological exam, 30 min routine EEG recording and neuropsychological evaluation along with the f-MRI study. (Hepatic Encephalopathy Group)
Exclusion criteria
* History of alcohol consumption or illicit drug use within past 3 months. * Patients with underlying psychiatric or neurologic illness (i.e. schizophrenia, untreated major depressive disorder, epilepsy, neurodegenerative dementia, etc.) resulting in unrelated to encephalopathy impairment of consciousness and/or alteration of normal mental capacity. * Patients after head injury or with advanced pulmonary, renal, or other than liver failure metabolic disorder (such as severe hypoxia, hypo/hyperglycemia, metabolic acidosis or alkalosis). * Patients requiring sedation for MRI. * Pregnant women. (Normal Control Group) Inclusion Criteria: * Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local subject privacy regulations. * Be age 18 or older at the time of informed consent. * Subjects must be right handed, be free from any neurological injury, be free from any neurological diseases, be free from any psychological diseases, have a baseline Blood pressure \< 140/90, not currently be taking any mind altering medications (including antidepressants, anxiolytics, or opioid/narcotic pain medications), and not have claustrophobia (Normal Control Group)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional MRI imagining | Participants will be followed until all study assessments have been completed, an expected average 4 weeks. | 4 Paradigms: 1. Resting 2. Tactile Touch 3. Motor 4. Auditory |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| EEG Testing | Participants will be followed until all study assessments have been completed, an expected average 4 weeks. | — |
| Neuropsychological Testing | Participants will be followed until all study assessments have been completed, an expected average 4 weeks. | WAIS-III PHES Digit Span and Trails |
| Neurological Examination | Participants will be followed until all study assessments have been completed, an expected average 4 weeks. | — |
| Serum Ammonia Level | Participants will be followed until all study assessments have been completed, an expected average 4 weeks. | Hepatic Encephalopathy Group only |
Countries
United States
Outcome results
None listed