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Prolonged N200 is the early neurophysiologic change in the patient with minimal hepatic encephalopathy

Title
Prolonged N200 is the early neurophysiologic change in the patient with minimal hepatic encephalopathy
Author
김창렬
Keywords
Event-related potentials; hepatic encephalopathy; minimal hepatic encephalopathy; N200; P300; psychometric hepatic encephalopathy score; EVOKED-POTENTIALS; NEUROPSYCHOLOGICAL TESTS; PSYCHOMETRIC TESTS; CIRRHOSIS; LIVER; DIAGNOSIS; IMPAIRMENT; SPECTRUM; MISMATCH; DISEASE
Issue Date
2014-03
Publisher
INFORMA HEALTHCARE, TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND
Citation
Scandinavian Journal of Gastroenterology, Volume 49, 2014 - Issue 5
Abstract
Background. In neurophysiological studies, P300, is well known for reflecting early cognitive impairment in minimal hepatic encephalopathy (MHE). Although P300 is investigated extensively, other early event-related potential (ERP) parameters have not been studied in MHE. Methods. The subjects were 21 adult cirrhotic patients without clinical encephalopathy and 29 normal controls. For neuropsychological testing, number connection tests, A and B (NCT-A, NCT-B), the line tracing test, the serial dotting test (SDT), and the digit symbol test (DST) were performed. For ERP testing, auditory oddball paradigms were used. The N100, P200, N200, and P300 parameters were measured. Results. Cirrhosis had longer neuropsychological performance scores on NCT-A, SDT, and DST than the control group. In neurophysiological test, cirrhotic patients showed longer latencies for N100, P200, N200, and P300 than the control group. Although P300 alteration was not seen in patients without MHE compared to the control group (325.4 +/- 43.3 vs. 345.21 +/- 35.1, p = 0.25), N200 latency was significantly prolonged in cirrhotic patients without MHE compared to the healthy group (242.1 +/- 30.3 vs. 259.58 +/- 33.3, p = 0.006). N200 also showed good correlation with psychometric hepatic encephalopathy score and critical flicker frequency. Conclusions. N200 is a useful tool for assessing early changes of cognitive dysfunction in cirrhosis. It suggests that slower auditory cortical processing is the first sign of cerebral deterioration in patients with hepatic encephalopathy.
URI
http://www.tandfonline.com/doi/full/10.3109/00365521.2013.878382http://hdl.handle.net/20.500.11754/44079
ISSN
1502-7708; 0036-5521
DOI
10.3109/00365521.2013.878382
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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