Altered Baseline Brain Activity In Patients With Hepatic Encephalopathy:a Resting-State FMRI Study

Objective:To investigate the baseline brain activity changed in patients with hepatic encephalopathy (HE) using fMRI.Methods:Thirty-six subjects including 12 patients with previous overt HE (OHE group),12 patients with minimal HE (MHE group) and 12 health controls (HC group) underwent resting-state fMRI scan. Amplitude of low-frequency fluctuation (ALFF) maps was used for statistical analysis.Results:Compared with HC group, OHE and MHE groups showed ALFF decreased in bilateral post cingulate cortex, left paracentral lobule and left supplementary motor area. Compared with MHE group, OHE group showed ALFF decreased in bilateral posterior cingulate cortex, left anterior cingulate cortex, bilateral medial prefrontal cortex, right angular gyrus, right superior occipital gyrus and right middle frontal gyrus (P<0.01). The ALFF in bilateral posterior cingulate cortex in both OHE and MHE groups showed negative correlation with blood ammonia level (P<0.01).Conclusion:Patients with HE exist brain dysfunction in resting-state. The decreased ALFF in posterior cingulate cortex may indicate persistent damage of brain function in patients with previous OHE.