Associations among neuropsychological performance, brain structural alterations, and glymphatic function in patients with minimal hepatic encephalopathy

IF 3.5 3区医学 Q2 NEUROSCIENCES

Brain Research Bulletin Pub Date : 2025-06-04 DOI:10.1016/j.brainresbull.2025.111416

Chao Ju , Longtao Yang , Zhongshang Dai , Yisong Wang , Chang Li , Wei Zhao , Yongfang Jiang , Haiyang Li , Jun Liu

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Abstract

Brain anatomical alterations in gray matter(GM), white matter(WM), and glymphatic system(GS) in patients with hepatitis B cirrhosis(HBC) with minimal hepatic encephalopathy(MHE) remain to be clarified. A total of 33 healthy controls and 37 patients with treatment-native primary HBC (further subdivided into HBC in MHE group[MHE] and HBC in non-MHE group[NMHE]) participated in neuroimaging study with three-dimensional T1 and a half q-space Cartesian grid diffusion model. Group differences in regional GM volume(GMV) were assessed using voxel-based morphometry(VBM) analysis. Differences in WM diffusion metrics were compared using tract-based spatial statistics(TBSS) analysis. Diffusion tensor image analysis along the perivascular space(DTI-ALPS) was employed to evaluate GS function. Compared to healthy control group (HC), GMV was reduced in MHE group, mainly in the vermis, bilateral pallidum, and right putamen, but was increased in right lateral geniculate thalamus(Thal_LGN_R) and left pulvinar medial thalamus(Thal_PuM_L). MHE patients displayed greater isotropic volume fraction(ISOVF) in the right sagittal stratum, right superior longitudinal fasciculus, left fornix(cres)/stria terminalis, left corticospinal tract, left cerebral peduncle, and left cingulum (hippocampus) than HC. DTI-ALPS was significantly downregulated in MHE patients. It revealed cortical changes, low-grade WM edema, and GS disorders at the early stage of chronic HBC, which will aid in MHE identification.

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轻度肝性脑病患者的神经心理表现、脑结构改变和淋巴功能之间的关系

乙型肝炎肝硬化（HBC）合并轻度肝性脑病（MHE）患者脑灰质（GM）、白质（WM）和淋巴系统（GS）的脑解剖学改变尚不清楚。采用三维T1和半q空间笛卡尔网格扩散模型，对33例健康对照者和37例治疗性原发性HBC患者（进一步分为MHE组HBC [MHE]和非MHE组HBC [NMHE]）进行神经影像学研究。使用基于体素的形态测量（VBM）分析评估区域GM体积（GMV）的组间差异。采用基于通道的空间统计（TBSS）分析比较WM扩散指标的差异。采用沿血管周围空间扩散张量图像分析（DTI-ALPS）评价GS功能。与健康对照组（HC）相比，MHE组GMV减少，主要集中在蚓部、双侧白质和右侧壳核，而右侧膝状丘脑外侧（Thal_LGN_R）和左侧pulvinar内侧丘脑（Thal_PuM_L） GMV增加。MHE患者在右侧矢状层、右侧上纵束、左侧穹窿/终纹、左侧皮质脊髓束、左侧脑蒂和左侧扣带（海马）的各向同性体积分数（ISOVF）高于HC。DTI-ALPS在MHE患者中显著下调。它揭示了慢性HBC早期的皮质改变、低级别WM水肿和GS紊乱，这将有助于MHE的识别。

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来源期刊

Brain Research Bulletin 医学-神经科学

CiteScore

6.90

自引率

2.60%

发文量

253

审稿时长

67 days

期刊介绍： The Brain Research Bulletin (BRB) aims to publish novel work that advances our knowledge of molecular and cellular mechanisms that underlie neural network properties associated with behavior, cognition and other brain functions during neurodevelopment and in the adult. Although clinical research is out of the Journal''s scope, the BRB also aims to publish translation research that provides insight into biological mechanisms and processes associated with neurodegeneration mechanisms, neurological diseases and neuropsychiatric disorders. The Journal is especially interested in research using novel methodologies, such as optogenetics, multielectrode array recordings and life imaging in wild-type and genetically-modified animal models, with the goal to advance our understanding of how neurons, glia and networks function in vivo.