Sarcopenia and cognitive impairment in liver cirrhosis: A viewpoint on the clinical impact of minimal hepatic encephalopathy.

Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE

Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-

Quality of Life*; Cognitive Dysfunction/*physiopathology ; Hepatic Encephalopathy/*etiology ; Liver Cirrhosis/*complications ; Sarcopenia/*etiology; Brain/physiopathology ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/etiology ; Female ; Hepatic Encephalopathy/diagnosis ; Hepatic Encephalopathy/physiopathology ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Sarcopenia/physiopathology ; Social Class

Minimal hepatic encephalopathy (MHE) represents the mildest type of hepatic encephalopathy (HE). MHE is considered as a preclinical stage of HE and is part of a wide spectrum of typical neurocognitive alterations characteristic of patients with liver cirrhosis, particularly involving the areas of attention, alertness, response inhibition, and executive functions. MHE can be detected by testing the patients' psychometric performance, attention, working memory, psychomotor speed, and visuospatial ability, as well as by means of electrophysiological and other functional brain measures. MHE is very frequent, affecting from 20% up to 80% of patients tested, depending of the diagnostic tools used. Although subclinical, MHE is considered to be clinically relevant. In fact, MHE has been related to the patients' falls, fitness to drive, and working ability. As a consequence, MHE affects the patients and caregivers lives by altering their quality of life and even their socioeconomic status. Recently sarcopenia, a very common condition in patients with advanced liver disease, has been shown to be strictly related to both minimal and overt HE. Aim of this review is to summarize the most recently published evidences about the emerging relationship between sarcopenia and cognitive impairment in cirrhotic patients and provide suggestions for future research.
Competing Interests: Conflict-of-interest statement: There are no conflicts of interest arising from this work.

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Keywords: Cirrhosis; Cognitive impairment; Minimal hepatic encephalopathy; Muscle alterations; Sarcopenia

Date Created: 20190928 Date Completed: 20200226 Latest Revision: 20200226

20240628

PMC6761233

10.3748/wjg.v25.i35.5257

31558871