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临床及生化指标正常的丙型肝炎病毒感染中认知功能障碍的脑微结构相关性

Brain Microstructural Correlates of Cognitive Dysfunction in Clinically and Biochemically Normal Hepatitis C Virus Infection.

作者信息

Kumar Ajay, Deep Amar, Gupta Rakesh K, Atam Virendra, Mohindra Samir

机构信息

Department of Medical Gastroenterology, King George's Medical University, Lucknow 226003, India.

Experimental and Public Health Lab, Department of Zoology, University of Lucknow, 226003, India.

出版信息

J Clin Exp Hepatol. 2017 Sep;7(3):198-204. doi: 10.1016/j.jceh.2017.03.011. Epub 2017 Apr 4.

Abstract

BACKGROUND/AIMS: This study examined correlates of the brain's neurocognitive performance among clinically and biochemically normal adult patient with hepatitis C virus (HCV). We hypothesized that anti-HCV positive individuals would demonstrate structural brain abnormalities and neurocognitive dysfunction as well as the changes in cell component and extracellular space in the white matter regions of brain in asymptomatic HCV infection by using diffusion tensor tractrography (DTT) metrics.

METHODS

Anti-HCV positive patient ( = 40), and healthy controls ( = 31), fulfilling inclusion criteria (incidentally detected anti-HCV positive) and able to provide informed consent were screened and recruited for the study. All these subjects and controls underwent subjective assessment of their quality of life related symptoms, neuropsychometric tests (NPT) and magnetic resonance imaging.

RESULTS

The patients were subjected to neuroimaging as well as psychological testing. There was no significant difference in basic laboratory parameters in these two groups. Independent -test reveals significantly lower neuropsychological functioning as compared to healthy control. A significantly decreased FA values and myoinsitol were observed in HCV subjects on sensory, inferior longitudinal fascicules, and STR fiber bundles as compared to healthy control. Bivariate correlation analysis reveals that neuropsychological scores are significantly positive.

CONCLUSION

Our result show that HCV positive individuals would demonstrate structural brain abnormalities and neurocognitive dysfunction as well as the changes in cell component and extracellular space in the white matter regions of brain in asymptomatic HCV infection by using DTT metrics.

摘要

背景/目的:本研究调查了临床和生化指标正常的丙型肝炎病毒(HCV)成年患者大脑神经认知功能的相关因素。我们假设,通过使用扩散张量纤维束成像(DTT)指标,抗HCV阳性个体在无症状HCV感染时会表现出脑结构异常、神经认知功能障碍以及脑白质区域细胞成分和细胞外空间的变化。

方法

筛选并招募符合纳入标准(偶然检测出抗HCV阳性)且能够提供知情同意书的抗HCV阳性患者(n = 40)和健康对照者(n = 31)参与本研究。所有这些受试者和对照者均接受了与生活质量相关症状的主观评估、神经心理测试(NPT)和磁共振成像检查。

结果

对患者进行了神经影像学和心理测试。两组的基本实验室参数无显著差异。独立样本t检验显示,与健康对照相比,患者的神经心理功能显著降低。与健康对照相比,HCV患者在感觉、下纵束和STR纤维束上的FA值和肌醇显著降低。双变量相关分析显示神经心理评分呈显著正相关。

结论

我们的结果表明,通过使用DTT指标,HCV阳性个体在无症状HCV感染时会表现出脑结构异常、神经认知功能障碍以及脑白质区域细胞成分和细胞外空间的变化。

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