Posted: 23-Feb-2005 << BACK
A report from the 2004 American Association for the Study of Liver Disease 55th Annual Conference
Background: Cognitive deficit was reported in hepatic cirrhosis even in early stages. Recent publications demonstrated cognitive impairment in patients with chronic HCV hepatitis even before the development of cirrhosis.
Aims: To check whether there is cognitive impairment in patients with chronic HCV hepatitis and to find the type of cognitive impairment.
Methods: A group of 28 patients with active chronic hepatitis C all planned for treatment with PEG interferon + Ribavirin was evaluated. Patients with impaired Mini Mental State Examination or with major depression were excluded previously. Ten volunteers with the same demegraphic parametrs were chosen as a control group. Both groups underwent a computerized neuropsychological assessment CogScan which included 15 psychologic tests: Finger Tapping Test (FTT), Inspection time (IT), Motion Perception Test (MPT), Simple Reaction Time (SRT), Choice Reaction Time, Immediate and Delayed Memory for Pictures, Words and Faces, Stroop test, Time-Accuracy Tradeoff test (TATT), Digit Symbol Substitution Test (DSST), and Continuous Performance test (CPT). Statistical analysis was performed using t-test for Equality of Means. Probability was estimated (p value<0.05).
Results: The patients with hepatitis C were found to be cognitively impaired in all subtests, exept sustained attention (CPT) versus control subjects. Most impairments were subtests of motor output, selective attention (Stroop test, accuracy), working memory and pair-associated learning (DSST test).
Conclusions: Patients with chronic HCV hepatitis have significant impairment in all stages of information processing. Deficits in performance on tests of selective attention, working memory and learning ability sugests an impairment in fronto-subcortical circuits, especialy in anterior cingulate girus. These functions have major importance in everyday activity, quality of life and driving skills. The correlation between severity of disease and degree of cognitive impairment may necessitate further investigation.
Doron Levi Zamir, Barzilai Hospital, Ashkelon, Israel; Simion Kerzman, Anima Scan, Ashdod, Israel; Steven Melnik, Ehud Melzer, Kaplan Hospital, Rehovot, Israel; Vaneli Maguli, Zoya Aladjem, Ron Milo, Zoya Aladjem, Barzilai Hospital, Ashkelon, Israel.
