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@ARTICLE{Winterdahl:866641,
      author       = {Winterdahl, Michael and Abbas, Zaheer and Noer, Ove and
                      Thomsen, Karen Louise and Gras, Vincent and Nahimi, Adjmal
                      and Vilstrup, Hendrik and Shah, Nadim Joni and Dam, Gitte},
      title        = {{C}erebral water content mapping in cirrhosis patients with
                      and without manifest {HE}},
      journal      = {Metabolic brain disease},
      volume       = {34},
      number       = {4},
      issn         = {1573-7365},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V},
      reportid     = {FZJ-2019-05720},
      pages        = {1071 - 1076},
      year         = {2019},
      abstract     = {Hepatic 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.},
      cin          = {INM-4 / INM-11 / JARA-BRAIN},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-11-20170113 /
                      $I:(DE-82)080010_20140620$},
      pnm          = {573 - Neuroimaging (POF3-573)},
      pid          = {G:(DE-HGF)POF3-573},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31089866},
      UT           = {WOS:000475697800012},
      doi          = {10.1007/s11011-019-00427-y},
      url          = {https://juser.fz-juelich.de/record/866641},
}