Category Archives: Liver-brain Axis

Predictive value of induced hyperammonaemia and neuropsychiatric profiling in relation to the occurrence of post-TIPS hepatic encephalopathy

Senzolo M, Zarantonello L, Formentin C, Orlando C, Beltrame F, Vuerich A, Angeli P, Burra P, Montagnese S Metabolic Brain Disease Hepatic encephalopathy (HE) occurs in 20–50% of patients after transjugular intrahepatic portosystemic shunt (TIPS) placement. Older age, HE history and severe liver failure have all been associated with post-TIPS HE but it remains difficult to […]

The Psychomotor Vigilance Task: Role in the Diagnosis of Hepatic Encephalopathy and Relationship with Driving Ability.

Formentin Chiara, De Rui Michele, Zoncapè Mirco, Ceccato Silvia, Zarantonello Lisa, Senzolo Marco, Burra Patrizia, Angeli Paolo, Amodio Piero, Montagnese Sara Journal of Hepatology BACKGROUND & AIMS: Hepatic Encephalopathy (HE) is a syndrome of decreased vigilance, and has been associated with impaired driving ability. The aim of this study was to evaluate the Psychomotor Vigilance […]

Hepatic encephalopathy 2018: A clinical practice guideline by the Italian Association for the Study of the Liver (AISF)

Sara Montagnese,Francesco Paolo Russo, Piero Amodio, Patrizia Burra, Antonio Gasbarrini, Carmela Loguercio, Giulio Marchesini, Manuela Merli, Francesca Romana Ponziani, Oliviero Riggio, Carmelo Scarpignato Digestive and Liver Disease Hepatic encephalopathy (HE) is a common, worrisome and sometimes difficult to manage complication of end-stage liver disease. HE is often recurrent, requiring multiple hospital admissions. It can have […]

Morning Bright Light Treatment for Sleep-Wake Disturbances in Primary Biliary Cholangitis: A Pilot Study

Matteo Turco, Nora Cazzagon, Irene Franceschet, Chiara Formentin, Giovanni Frighetto, Francesca Giordani, Nicola Cellini, Gabriella Mazzotta, Rodolfo Costa, Benita Middleton, Debra J. Skene, Annarosa Floreani and Sara Montagnese Frontiers in Physiology Patients with Primary Biliary Cholangitis (PBC) exhibit delayed sleep-wake habits, disturbed night sleep and daytime sleepiness/fatigue. Such combination of symptoms is reminiscent of delayed […]

Assessment and Management of Sleep Disturbance in Cirrhosis

Formentin C,  Garrido M,  Montagnese S. Current Hepatology Reports This review presents an in-depth overview of the sleep–wake phenotype of patients with cirrhosis, together with available pharmacological and non-pharmacological treatment strategies. A set of simple, practical recommendations is also provided. The understanding of the pathophysiology of sleep disorders in this patient population has improved over the […]

Neuropsychiatric performance and treatment of hepatitis C with direct-acting antivirals: a prospective study

Volpato S, Montagnese S, Zanetto A, Turco M, De Rui M, Ferrarese A, Amodio P, Germani G, Senzolo M, Gambato M, Russo FP, Burra P. BMJ open gastroenterology 2017 BACKGROUND:Since direct-acting antivirals (DAAs) have been approved for the treatment of hepatitis C virus (HCV) infection, a small series of patients with new-onset neuropsychiatric alterations have been referred to us. We therefore set out to study neuropsychiatricfunction in […]

The animal naming test: An easy tool for the assessment of hepatic encephalopathy.

Campagna F, Montagnese S, Ridola L, Senzolo M, Schiff S, De Rui M, Pasquale C, Nardelli S, Pentassuglio I, Merkel C, Angeli P, Riggio O, Amodio P. Hepatology. 2017 Screening for hepatic encephalopathy (HE) that does not cause obvious disorientation or asterixis (minimal HE [MHE]/grade 1 HE) is important. We examined if the animal naming test (ANT1 ) (maximum number of animals listed […]

Neuropsychiatric performance in patients with cirrhosis: Who is “normal”?

Montagnese S, De Rui M, Angeli P, Amodio P. Journal of Hepatology  2017 In patients with cirrhosis a normal neuropsychiatric performance has been traditionally defined by the absence of any degree of hepatic encephalopathy and/or the absence of psychometric or neurophysiological abnormalities, compared with data from the healthy population. As the understanding and management of end-stage liver disease continues to change, it is our impression […]

Cognitive reserve is a resilience factor for cognitive dysfunction in hepatic encephalopathy

Amodio P, Montagnese S, Spinelli G, Schiff S, Mapelli D. Metababolic Brain Disease  2017 Cognitive Reserve (CR) modulates symptoms of brain disease. The aim of this study was: to evaluate the effect of CR on cognition in cirrhosis and on the mismatch between cognitive and neurophysiologic assessment of hepatic encephalopathy (HE). Eighty-two outpatient patients with cirrhosis without overt HE were studied [73% […]