期刊
ACTA NEUROLOGICA SCANDINAVICA
卷 122, 期 1, 页码 27-35出版社
WILEY-BLACKWELL
DOI: 10.1111/j.1600-0404.2009.01246.x
关键词
ataxia; critical flicker frequency; hepatic encephalopathy; metabolic disorder; neurophysiology; tremor
资金
- Deutsche Forschungsgemeinschaft (DFG) [SFB 575, PO 806/2-2]
- 'Manfred-and-Ursula-Mueller Foundation'
- Boehringer Ingelheim
Aim - Manifest hepatic encephalopathy (HE) goes along with motor symptoms such as ataxia, mini-asterixis, and asterixis. The relevance of motor impairments in cirrhotics without and with minimal HE (mHE) is still a matter of debate. Patients and methods - We tested three different groups of patients with liver cirrhosis: no signs of HE (HE 0), mHE, and manifest HE grade 1 according to the West Haven criteria (HE 1). All patients (n = 24) and 11 healthy control subjects were neuropsychometrically tested including critical flicker frequency (CFF), a reliable measure for HE. Motor abilities were assessed using Fahn Tremor Scale and International Ataxia Rating Scale. Fastest alternating index finger movements were analyzed for frequency and amplitude. Results - Statistical analyses showed an effect of HE grade on tremor and ataxia (P < 0.01). Additionally, both ratings yielded strong negative correlation with CFF (P < 0.01, R = -0.5). Analysis of finger movements revealed an effect of HE grade on movement frequency (P < 0.03). Moreover, decreasing movement frequency and increasing movement amplitude parallel decreasing CFF (P < 0.01, R = 0.6). Conclusion - Our results indicate that ataxia, tremor, and slowing of finger movements are early markers for cerebral dysfunction in HE patients even prior to neuropsychometric alterations becoming detectable.
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