Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy

International Journal of Environmental Research and Public Health

Agnieszka Stawicka¹  Magdalena Świderska¹  Natalia Sołowianowicz¹  Jerzy Jaroszewicz¹  Robert Flisiak¹  Justyna Zbrzeźniak¹  Aleksandra Woszczenko¹ 

[1] Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland;

关键词: minimal hepatic encephalopathy;    MHE;    liver encephalopathy;    liver cirrhosis;    inhibitory control test;    ICT;   

DOI  :  10.3390/ijerph17103645

来源: DOAJ

【 摘 要 】

Background: Minimal hepatic encephalopathy (MHE) refers to a number of neuropsychiatric and neurophysiological disorders in patients with cirrhosis who do not show abnormalities on physical examination or in clinical tests. The aim of this study was to determine the prevalence, risk factors, and predictive value of minimal hepatic encephalopathy and the usefulness of the inhibitory control test (ICT) in the diagnosis. Methods: Seventy patients (mean age 53 years, range 24−77) with liver cirrhosis were enrolled in the study. MHE was diagnosed based on PHES (psychometric hepatic encephalopathy score) and ICT. PHES and ICT were validated in a group of 56 control subjects. Results: Minimal hepatic encephalopathy was diagnosed using PHES in 21 patients (30%). ICT diagnosed MHE in 30 patients (42%), and the test had a sensitivity of 65% and a specificity of 57% compared to PHES. The ICT score (lures/target accuracy rate) correlated with the age of subjects (R = 0.35, p = 0.002) and only slightly with education (education in years R = −0.22, p = 0.06). MHE diagnosed with PHES or ICT was associated with a significantly higher model of end-stage liver disease (MELD) score in the follow-up. MHE diagnosed with ICT was correlated with a significantly higher incidence of symptoms of decompensated cirrhosis (p = 0.02) in the follow-up. Conclusions: ICT had moderate sensitivity and specificity in diagnosing MHE compared to PHES. Importantly, MHE detected with PHES or ICT was associated with poorer survival and a more severe progression of the disease.

【 授权许可】

Unknown