Conclusion Oral zinc supplementation improved performance on the number connection test , but no evidence about other clinical or biochemical outcomes was available
Background and aim Because low serum zinc levels precipitate hepatic encephalopathy , zinc supplementation is considered a potential therapeutic option .
The aim of this study was to assess the effects of oral zinc supplementation in the treatment of hepatic encephalopathy .
Hepatic encephalopathy: A neurochemical, neuroanatomical, and neuropsychological study
Hepatic encephalopathy ( HE ) is normally diagnosed by neuropsychological ( NP ) tests , which are not very specific and do not reveal the underlying pathology . Magnetic resonance imaging ( MRI ) and spectroscopy ( MRS ) of the brain offer alternative and possibly more specific markers for HE . These methods were applied in conjunction with NP testing in order to determine their usefulness in the identification of HE and to underst and the pathogenesis of HE more clearly . MR imaging and spectroscopy examinations , in addition to a battery of 15 NP tests , were administered to investigate 31 patients awaiting liver transplantation and 23 healthy controls . MR image intensities from the globus pallidus region were calculated and normalized to those of the thalamus . Absolute concentrations and ratios with respect to creatine ( Cr ) of several metabolites were computed from MR spectra . The MR data were correlated with the results of NP tests . The patients showed impairment in NP tests of attention and visuospatial and verbal fluency . In T1 weighted MRI , the relative intensity of the globus pallidus with respect to that of the thalamus region was significantly elevated in patients and correlated ( negatively ) with three NP tests ( Hooper , FAS , and Trails B ) . The absolute concentrations of myo‐inositol ( mI ) and choline ( Ch ) were significantly reduced in three brain regions . In addition , the absolute concentrations of glutamine ( Gln ) and combined glutamate and glutamine ( Glx ) were increased in all three locations , with Gln increase being significant in all areas while that of Glx only in the occipital white matter . In summary , this study partially confirms a hypothesized mechanism of HE pathogenesis , an increased synthesis of glutamine by brain glutamate in astrocytes due to excessive blood ammonia , followed by a compensatory loss of myo‐inositol to maintain astrocyte volume homeostasis . It also indicates that the hyperintensity observed in globus pallidus could be used as complementary to the NP test scores in evaluating the mental health of HE patients . PACS number :
Conclusion Oral zinc supplementation improved performance on the number connection test , but no evidence about other clinical or biochemical outcomes was available
Background and aim Because low serum zinc levels precipitate hepatic encephalopathy , zinc supplementation is considered a potential therapeutic option .
The aim of this study was to assess the effects of oral zinc supplementation in the treatment of hepatic encephalopathy .