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000866641 1001_ $$0P:(DE-HGF)0$$aWinterdahl, Michael$$b0
000866641 245__ $$aCerebral water content mapping in cirrhosis patients with and without manifest HE
000866641 260__ $$aDordrecht [u.a.]$$bSpringer Science + Business Media B.V$$c2019
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000866641 520__ $$aHepatic encephalopathy (HE) is a frequent and debilitating complication of cirrhosis and its pathogenesis is not definitively clarified. Recent hypotheses focus on the possible existence of low-grade cerebral edema due to accumulation of osmolytes secondary to hyperammonemia. In the present study we investigated increases in cerebral water content by a novel magnetic resonance impedance (MRI) technique in cirrhosis patients with and without clinically manifest HE. We used a 3 T MRI technique for quantitative cerebral water content mapping in nine cirrhosis patients with an episode of overt HE, ten cirrhosis patients who never suffered from HE, and ten healthy aged-matched controls. We tested for differences between groups by statistical non-parametric mapping (SnPM) for a voxel-based spatial evaluation. The patients with HE had significantly higher water content in white matter than the cirrhosis patients (0.6%), who in turn, had significantly higher content than the controls (1.7%). Although the global gray matter water content did not differ between the groups, the patients with HE had markedly higher thalamic water content than patients who never experienced HE (6.0% higher). We found increased white matter water content in cirrhosis patients, predominantly in those with manifest HE. This confirms the presence of increasing degrees of low-grade edema with exacerbation of pathology. The thalamic edema in manifest HE may lead to compromised basal ganglia-thalamo-cortical circuits, in accordance with the major clinical symptoms of HE. The identification of the thalamus as particularly inflicted in manifest HE is potentially relevant to the pathophysiology of HE.
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000866641 7001_ $$0P:(DE-Juel1)140186$$aAbbas, Zaheer$$b1
000866641 7001_ $$0P:(DE-HGF)0$$aNoer, Ove$$b2
000866641 7001_ $$0P:(DE-HGF)0$$aThomsen, Karen Louise$$b3
000866641 7001_ $$0P:(DE-Juel1)131765$$aGras, Vincent$$b4
000866641 7001_ $$0P:(DE-HGF)0$$aNahimi, Adjmal$$b5
000866641 7001_ $$0P:(DE-HGF)0$$aVilstrup, Hendrik$$b6
000866641 7001_ $$0P:(DE-Juel1)131794$$aShah, Nadim Joni$$b7
000866641 7001_ $$00000-0003-3526-0171$$aDam, Gitte$$b8$$eCorresponding author
000866641 773__ $$0PERI:(DE-600)2018067-6$$a10.1007/s11011-019-00427-y$$gVol. 34, no. 4, p. 1071 - 1076$$n4$$p1071 - 1076$$tMetabolic brain disease$$v34$$x1573-7365$$y2019
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