Sabry Reem M, Hamad Osama, Khalil Hossam Eldin Mohamed, Mohammed Sahar Ibrahim, Eid Ragaey Ahmad, Hosny Hanan
Department of Clinical Neurophysiology (Neuro-Diagnostic and Research Center), Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Department of Gastroenterology, Hepatology and Infectious Diseases (Tropical Medicine department), Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
BMC Neurol. 2025 Feb 4;25(1):45. doi: 10.1186/s12883-025-04031-9.
Minimal hepatic encephalopathy (MHE) is one of the most debilitating complications of hepatic cirrhosis, and visual electrophysiology, visual evoked potential (VEP) has long been used for MHE diagnosis. This technique only produces a summed response that is greatly dominated by the macular region. Multifocal visual evoked potential (mfVEP) imaging minimizes these limitations because it allows topographic recording of the optic nerve and visual cortex. The aim of this study was to detect minimal hepatic encephalopathy among cirrhotic patients using the mfVEP in comparison to the validated psychometric hepatic encephalopathy score (PHES), paired associative learning (PAL) and the Benton visual retention test (BVRT).
Forty-five patients with compensated hepatic cirrhosis were enrolled in our study and compared to 45 normal controls who were matched for age, sex and educational level. Both groups underwent psychological tests (PHES, PAL, BVRT) and neurophysiological tests (mfVEP).
1According to the validated PHES, 14 patients were found to have MHE, 15 patients were found to have abnormal mfVEP, and abnormalities in the BVRT and PAL were found in 11 and 10 patients, respectively. 2-mfVEP showed the highest sensitivity in the detection of MHE in reference to the PHES. 3- The mfVEP test and potentially the BVRT have the advantage of detecting subtle abnormalities in non-MHE cirrhotic patients, for further research and follow-up are needed.
mfVEP demonstates promising results for objective early detection of MHE, with a sensitivity of approximately 92.9%.
轻微肝性脑病（MHE）是肝硬化最使人衰弱的并发症之一，视觉电生理，即视觉诱发电位（VEP）长期以来一直用于MHE的诊断。这项技术仅产生一个主要由黄斑区域主导的总和反应。多焦视觉诱发电位（mfVEP）成像将这些局限性最小化，因为它允许对视神经和视觉皮层进行地形图记录。本研究的目的是使用mfVEP与经过验证的心理测量肝性脑病评分（PHES）、配对联想学习（PAL）和本顿视觉保持测验（BVRT）相比，检测肝硬化患者中的轻微肝性脑病。
45例代偿期肝硬化患者纳入本研究，并与45名年龄、性别和教育水平相匹配的正常对照进行比较。两组均接受心理测试（PHES、PAL、BVRT）和神经生理测试（mfVEP）。
mfVEP在客观早期检测MHE方面显示出有前景的结果，敏感性约为92.9%。
