Brain involvement in non-alcoholic fatty liver disease (NAFLD): A systematic review

Rosa Lombardi, Silvia Fargion, Anna Ludovica Fracanzani

Research output: Contribution to journalArticlepeer-review


Non-alcoholic fatty liver disease (NAFLD) is associated with high cardiovascular morbidity and mortality which usually is considered to be related to cardiac involvement, while scarce attention is addressed to brain damage. Viceversa NAFLD is associated with asymptomatic brain lesions, alterations in cerebral perfusion and activity, cognitive impairment and brain aging and with increased risk and severity of both ischemic and haemorrhagic stroke. Besides known metabolic risk factors, NAFLD is characterized by a pro inflammatory state, which contributes to atherosclerosis and microglia activation, endothelial dysfunction, pro-coagulant state and platelets activation, which in turn promote both micro and macrovascular damage eventually responsible for clinical and subclinical cerebrovascular alterations. A better knowledge of the association between NAFLD and brain alterations could lead to an improved management of risk factors underpinning both liver and cerebral disease, possibly preventing the progression of asymptomatic brain lesions to clinical cerebrovascular accidents.

Original languageEnglish
Pages (from-to)1214-1222
Number of pages9
JournalDigestive and Liver Disease
Issue number9
Publication statusPublished - Sep 2019


  • Cognitive impairment
  • Liver steatosis
  • Neurological damage
  • Stroke disability

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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