Sha Guanchen, Liu Yuefan, Cao Yutong, Zhang Qi, Zhang Yining, Chen Yuanyuan, Fan Qiuyun, Cheng Yue
Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, 300072, China.
Tianjin Key Laboratory of Brain Science and Neuroengineering, Tianjin, 300072, China.
Magn Reson Lett. 2024 Oct 20;5(2):200156. doi: 10.1016/j.mrl.2024.200156. eCollection 2025 May.
Hepatic encephalopathy (HE) is a neurological condition that occurs as a complication of liver dysfunction that involves sensorimotor symptoms in addition to cognitive and behavioral changes, particularly in cases of severe liver disease or cirrhosis. Previous studies have reported spatially distributed structural and functional abnormalities related to HE, but the exact relationship between the structural and functional alterations with respect to disease progression remains unclear. In this study, we performed surface-based cortical thickness comparisons and functional connectivity (FC) analyses between three cross-sectional groups: healthy controls (HC, = 51), patients with minimal hepatic encephalopathy (MHE, = 50), patients with overt hepatic encephalopathy (OHE, = 51). In addition to the distributed cortical thinning that is extensively thought to be associated with cognitive decline in HE, we found significant cortical thickening in the left parahippocampal gyrus cortex in the OHE group ( < 0.001, = 0.009) as compared to the HC and MHE group respectively, which is further corroborated by the significant correlation between the cortical thickness and digit symbol test (DST) scores. Furthermore, the decreased FC between the right postcentral gyrus and several sensory regions (bilateral somatosensory and visual cortices) was found to be significant in MHE patients as compared to the HC group. Our results revealed cross-sectional structural and functional variations concerning disease progression across different subsystems (e.g., visual, motor and sensory), providing evidence that can potentially explain the mechanisms underlying the sensorimotor and cognitive deficits related to HE.
肝性脑病（HE）是一种神经系统疾病，作为肝功能障碍的并发症出现，除了认知和行为改变外，还涉及感觉运动症状，特别是在严重肝病或肝硬化病例中。先前的研究报告了与HE相关的空间分布的结构和功能异常，但结构和功能改变与疾病进展的确切关系仍不清楚。在本研究中，我们对三个横断面组进行了基于表面的皮质厚度比较和功能连接（FC）分析：健康对照组（HC，n = 51）、轻微肝性脑病患者（MHE，n = 50）、显性肝性脑病患者（OHE，n = 51）。除了广泛认为与HE认知下降相关的弥漫性皮质变薄外，我们发现与HC组和MHE组相比，OHE组左侧海马旁回皮质有显著的皮质增厚（p < 0.001，FDR = 0.009），皮质厚度与数字符号测试（DST）分数之间的显著相关性进一步证实了这一点。此外，与HC组相比，MHE患者右侧中央后回与几个感觉区域（双侧体感和视觉皮质）之间的FC降低具有显著性。我们的结果揭示了不同子系统（如视觉、运动和感觉）在疾病进展过程中的横断面结构和功能变化，为潜在解释与HE相关的感觉运动和认知缺陷的机制提供了证据。
