Currently existing methods of hepatic encephalopathy (HE) diagnostics at patients with liver cirrhosis, including psychometric tests, measuring ammonia level, electro-encephalography, magnetic resonance spectroscopy and other methods, are either not sensitive and specific enough, or are too expensive.
Our goal was to evaluate the method of cognitive evoked brain potentials in diagnostics and evaluation of hepatic encephalopathy dynamics at patients with liver cirrhosis who receive a complex therapy.
Materials and methods
We examined and treated 25 patients with liver cirrhosis of classes А and В according to Child-Pugh, with HE of 0-2 stage. The test group consisted of 15 men and 10 women aged between 38 and 63 years old (average age 49,9±1,5). Beside the common therapy that included detoxification measures, hepatoprotectors, aldosterone blockers and preparation «Dufalak» (Solvay Pharma) in dose 45-60 ml/day during 30 days, all patients received a course of crio-apheresis (from 5 till 7 treatment procedures). Method of cognitive evoked brain potentials or P300 was applied in order to analyze cognitive processes in the brain. Using method P300, we studied slowing dynamics of interpeak latency before and after the therapy. The study was conducted using multifunctional computer equipment «Neuro-MVP».
We analyzed the results of the research on the cognitive evoked brain potentials, and saw an obviously bigger latency of peak Р300 at all test persons. Average Р300 wave was 531,1±10,8 ms. Normal latency in this age group should not exceed 361 ms. These data proved a clear disruption of cognitive functions, which was probably not related to defective identification of important stimulus, but was rather connected with defects in memorizing and operative memory of events. Positive dynamics was observed after the treatment: the latency of component Р300 decreased (р<0,001), its average value reached 424,2±7,2 ms.
To sum up, quantitative parameters of interpeak latency (P300) could be used as criteria in the evaluation of treatment effectiveness for hepatic encephalopathy, and improve its control.
The work was submitted to the International Scientific Conference «Medical, social and economic problems of population health preservation», Kemer (Turkey), May 20-27, 2009. Came to the editorial office on 30.04.2009.