A role of neuropsychological test in the patients with chronic liver disease.
- Author:
Jai Won BYUN
1
;
Geun Tae PARK
;
Jang Han LEE
;
Sun I KIM
;
Ho Soon CHOI
;
Dong Hyun AHN
;
Byung Ik KIM
;
Min Ho LEE
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. minho@hmc.hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Hepatic encephalopathy;
Neuropsychological test;
Liver cirrhosis
- MeSH:
Child;
Classification;
Diagnosis;
Fingers;
Hepatic Encephalopathy;
Humans;
Liver Cirrhosis;
Liver Diseases*;
Liver*;
Memory;
Motor Skills;
Neuropsychological Tests*;
Psychometrics;
Quality of Life;
Wisconsin
- From:Korean Journal of Medicine
2004;66(2):135-146
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Minimal (subclinical) hepatic encephalopathy (mHE) currently diagnosed by psychometric tests or neurophysiological test adversely affects daily functioning. In view of its sociomedical relevance, simple and reproducible tests for routine diagnosis are required. The aims of this study are to evaluate cognitive function of patients with chronic liver disease by computerized neuropsychological test (STIM), and the difference of cognitive function according to Child classification. METHODS: Between June, 2002 and February, 2003 We enrolled 61 randomized consecutive patients diagnosed with chronic liver disease by biochemical tests, ultrasonographic finding or histology. This study used finger tapping, visual CPT, spatial memory test, Wisconsin card sorting test chosen from Neuscan and STIM system (Neurosoft company, U.S.A) and global-local processing test. RESULTS: In the present study, significant correlation was found between neurologic abnormalities and the degree of liver disease. The result of neuropsychological test showed that cognitive function was decreased according to the severity of chronic liver disease, especially liver cirrhosis. Cirrhotic patients, especially Child C group, exhibited selective deficits in complex attentional and fine motor skills, visuospatial perception, with preservation of memory. CONCLUSION: The STIM in this study is simple, objective and reproducible method because it can subdivide evaluation of cognitive function and computerize the measurement of response. We assume that STIM may be used early detection method of mHE if the study will be in a large scale. Because psychomotor deficits found in mHE could have a disadvanting influence on daily functioning of patients, e.g., driving abilty of a car or performance at work, we concluded early detection of mHE and aggressive treatment of mHE in clinically asymptomatic cirrhotic patients is necessary for improvement of their quality of life.
