Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease—Current Knowledge, Mechanisms and Perspectives

Journal of Clinical Medicine

卷:10

LeaLadegaard Grønkjær¹  CharlotteWilhelmina Wernberg¹  MetteMunk Lauridsen¹  Hendrik Vilstrup²  KarenLouise Thomsen²  RajeshwarProsad Mookerjee²  PeterLykke Eriksen²  Kristoffer Kjærgaard²  AnneCatrine Daugaard Mikkelsen²  MaleneFlensborg Damholdt³ 

[1] Department of Gastroenterology and Hepatology, Hospital of South West Jutland, Finsensgade 35, 6700 Esbjerg, Denmark;

[2] Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, C117, 8200 Aarhus N, Denmark;

[3] Institute of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 11, 8000 Aarhus C, Denmark;

关键词: non-alcoholic steatohepatitis;    cognition;    inflammation;    ammonia;    vascular dysfunction;    neurodegeneration;   

DOI  :  10.3390/jcm10040673

来源: DOAJ

【 摘 要 】

Non-alcoholic fatty liver disease (NAFLD) has emerged as the hepatic component of the metabolic syndrome and now seemingly affects one-fourth of the world population. Features associated with NAFLD and the metabolic syndrome have frequently been linked to cognitive dysfunction, i.e. systemic inflammation, vascular dysfunction, and sleep apnoea. However, emerging evidence suggests that NAFLD may be a cause of cognitive dysfunction independent of these factors. NAFLD in addition exhibits dysbiosis of the gut microbiota and impaired urea cycle function, favouring systemic ammonia accumulation and further promotes systemic inflammation. Such disruption of the gut–liver–brain axis is essential in the pathogenesis of hepatic encephalopathy, the neuropsychiatric syndrome associated with progressive liver disease. Considering the growing burden of NAFLD, the morbidity from cognitive impairment is expected to have huge societal and economic impact. The present paper provides a review of the available evidence for cognitive dysfunction in NAFLD and outlines its possible mechanisms. Moreover, the clinical challenges of characterizing and diagnosing cognitive dysfunction in NAFLD are discussed.

【 授权许可】

Unknown