Details

Autor(en) / Beteiligte

• Solinas, Antonio
• Piras, Maria Rita
• Deplano, Angelo

Titel

Cognitive dysfunction and hepatitis C virus infection

Ist Teil von

• World journal of hepatology, 2015-05, Vol.7 (7), p.922-925

Ort / Verlag

United States: Baishideng Publishing Group Inc

Erscheinungsjahr

2015

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Cognitive dysfunction in patients with chronic hepatitisC virus （HCV） infection is a distinct form of minimalhepatic encephalopathy （MHE）. In fact, the majority ofHCV-positive patients, irrespective of the grading of liverfibrosis, display alterations of verbal learning, attention,executive function, and memory when they are evaluatedby suitable neuropsychological tests. Similarities betweenthe cognitive dysfunction of HCV patients and MHE ofpatients with different etiologies are unclear. It is alsounknown how the metabolicalterations of advancedliver diseases interact with the HCV-induced cognitivedysfunction, and whether these alterations are reversedby antiviral therapies. HCV replication in the brain mayplay a role in the pathogenesis of neuroinflammation.HCV-related brain dysfunction may be associated withwhite matter neuronal loss, alterations of associationtracts and perfusion. It is unclear to what extent, inpatients with cirrhosis, HCV triggers an irreversibleneurodegenerative brain damage. New insights on thisissue will be provided by longitudinal studies using theprotocols established by the diagnostic and statisticalmanual of mental disorders fifth edition for cognitivedisorders. The domains to be evaluated are complexattention; executive functions; learning and memory;perceptual motor functions; social cognition. Theseevaluations should be associated with fluorodeoxyglucosepositron emission tomography and magnetic resonanceimaging （MRI） protocols for major cognitive disordersincluding magnetic resonance spectroscopy, diffusiontensor imaging, magnetic resonance perfusion, andfunctional MRI. Also, the characteristics of portalhypertension, including the extent of liver blood flow andthe type of portal shunts, should be evaluated.