Subtle Cognitive Impairments in Advanced Liver Disease Cases

Abstract

Subtle cognitive disturbances may arise in individuals with advanced liver disease even in the absence of obvious neurological symptoms. These early alterations, referred to as minimal hepatic encephalopathy (mHE), are typically undetectable without specialized assessments, yet they can impact quality of life and daily function. Recognizing such impairments early is crucial for halting or slowing progression to more serious neurological decline.

This investigation focused on detecting mHE among adults with decompensated liver function. A total of 60 participants, aged between 40 and 65, were assessed, including both affected individuals and healthy controls. The clinical status of patients with liver disease was stratified using a common liver function scoring system. Cognitive performance was evaluated through standard neuropsychological tools, alongside more targeted assessments for subtle deficits.

Differences in test outcomes between patients and controls were statistically significant. In addition, all individuals with liver impairment exhibited notable changes in brain wave activity. A substantial proportion about four out of five showed signs consistent with early neurological dysfunction. Performance on specific tests was found to correlate with the severity of liver dysfunction, and one test, in particular, appeared more sensitive in detecting early changes.

These results highlight the prevalence of mHE in this patient population and emphasize the value of early cognitive screening to prevent further neurological deterioration.