The authors studied 6 patients with end-stage cirrhosis and 6 age- and
sex-matched normal control subjects by using SPECT brain scans to determine
whether subclinical hepatic encephalopathy (HE) altered regional cerebral
blood flow (rCBF). In addition, cirrhosis patients performed a battery of
standardized neuropsychological tests known to be sensitive to effects of
liver disease, and these were compared with published norms. Results of
cognitive tests that showed impairment were correlated with ratios of rCBF
values. In cirrhosis patients, rCBF was decreased in bilateral
frontotemporal and right basal ganglia regions as compared with control
subjects. These defects were compatible with the cirrhosis patients'
visuopractic neuropsychological deficits, which were consistent with known
subclinical HE cognitive patterns.