Electroencephalography in patients with cirrhosis

Piergiorgio Marchetti, Costanza D'Avanzo, Raffaele Orsato, Sara Montagnese, Sami Schiff, Peter W. Kaplan, Francesco Piccione, Carlo Merkel, Angelo Gatta, Giovanni Sparacino, Gianna Maria Toffolo, Piero Amodio

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background & Aims: Electroencephalography has not been completely quantified in patients with cirrhosis. We investigated the electroencephalogram (EEG) dynamics in patients with cirrhosis. Methods: We performed closed-eye EEGs on 175 patients with cirrhosis (age, 55 ± 11 years; 24% Child-Pugh class A, 48% class B, and 285 class C), conducted clinical and psychometric assessments for hepatic encephalopathy (HE), and followed the patients for 1 year. EEG characteristics were assessed in the frequency domain, in the frontal (F3-F4) and parietal (P3-P4) derivations. Intrahemispheric (frontoparietal, right, and left) and interhemispheric (F3-F4 and P3-P4) coherence were computed. The EEGs of 50 healthy volunteers (age, 56 ± 17 years) served as controls. Results: Compared with controls, the EEGs of patients with cirrhosis had a reduced frequency in the posterior derivations (P3/P4 mean dominant frequency, 9.1 ± 1.8 and 8.9 ± 1.7 Hz vs 10.4 ± 1.3 and 10.2 ± 1.3 Hz, respectively; P <.01) and an increase in interhemispheric parietal relative coherence within the theta band (22.3% ± 5.5% vs 18.9% ± 3.5%; P <.01). These features were more prominent in patients with Child class C and in patients with a history of overt HE; they correlated with hyperammonemia and hyponatremia. The decrease in EEG frequency, along with the increase in interhemispheric theta coherence in the posterior derivations, was inversely associated with survival and the occurrence of overt HE during the follow-up period. Conclusions: In patients with cirrhosis, alterations in the EEG were significantly associated with the severity of liver disease and HE; the EEG might be used in determining prognosis.

Original languageEnglish
Pages (from-to)1680-1689
Number of pages10
JournalGastroenterology
Volume141
Issue number5
DOIs
Publication statusPublished - Nov 2011

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Electroencephalography
Fibrosis
Hepatic Encephalopathy
Hyperammonemia
Hyponatremia
Psychometrics
Liver Diseases
Healthy Volunteers
Survival

Keywords

  • Brain
  • Frequency Analysis
  • Minimal Hepatic Encephalopathy
  • Nervous System
  • Neurophysiology

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Marchetti, P., D'Avanzo, C., Orsato, R., Montagnese, S., Schiff, S., Kaplan, P. W., ... Amodio, P. (2011). Electroencephalography in patients with cirrhosis. Gastroenterology, 141(5), 1680-1689. https://doi.org/10.1053/j.gastro.2011.06.085

Electroencephalography in patients with cirrhosis. / Marchetti, Piergiorgio; D'Avanzo, Costanza; Orsato, Raffaele; Montagnese, Sara; Schiff, Sami; Kaplan, Peter W.; Piccione, Francesco; Merkel, Carlo; Gatta, Angelo; Sparacino, Giovanni; Toffolo, Gianna Maria; Amodio, Piero.

In: Gastroenterology, Vol. 141, No. 5, 11.2011, p. 1680-1689.

Research output: Contribution to journalArticle

Marchetti, P, D'Avanzo, C, Orsato, R, Montagnese, S, Schiff, S, Kaplan, PW, Piccione, F, Merkel, C, Gatta, A, Sparacino, G, Toffolo, GM & Amodio, P 2011, 'Electroencephalography in patients with cirrhosis', Gastroenterology, vol. 141, no. 5, pp. 1680-1689. https://doi.org/10.1053/j.gastro.2011.06.085
Marchetti P, D'Avanzo C, Orsato R, Montagnese S, Schiff S, Kaplan PW et al. Electroencephalography in patients with cirrhosis. Gastroenterology. 2011 Nov;141(5):1680-1689. https://doi.org/10.1053/j.gastro.2011.06.085
Marchetti, Piergiorgio ; D'Avanzo, Costanza ; Orsato, Raffaele ; Montagnese, Sara ; Schiff, Sami ; Kaplan, Peter W. ; Piccione, Francesco ; Merkel, Carlo ; Gatta, Angelo ; Sparacino, Giovanni ; Toffolo, Gianna Maria ; Amodio, Piero. / Electroencephalography in patients with cirrhosis. In: Gastroenterology. 2011 ; Vol. 141, No. 5. pp. 1680-1689.
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