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Abstract Details
A New Score Unveils a High Prevalence of Mild Cognitive Impairment in Patients with Nonalcoholic Fatty Liver Disease
J Clin Med. 2021 Jun 25;10(13):2806. doi: 10.3390/jcm10132806.
Carla Giménez-Garzó12, Alessandra Fiorillo2, María-Pilar Ballester-Ferré23, Juan-José Gallego2, Franc Casanova-Ferrer2, Amparo Urios12, Salvador Benlloch45, David Martí-Aguado23, Teresa San-Miguel6, Joan Tosca23, María-Pilar Ríos4, Cristina Montón23, Lucía Durbán4, Desamparados Escudero-García237, Luis Aparicio8, Vicente Felipo1, Carmina Montoliu26
Author information
1Laboratory of Neurobiology, Centro Investigación Príncipe Felipe, 46012 Valencia, Spain.
2Fundación Investigación Hospital Clínico, Instituto de Investigación Sanitaria, INCLIVA, 46010 Valencia, Spain.
3Servicio de Medicina Digestiva, Hospital Clínico Valencia, 46010 Valencia, Spain.
4Servicio de Digestivo, Hospital Arnau de Vilanova, 46015 Valencia, Spain.
5CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain.
6Departamento de Patología, Universidad Valencia, 46010 Valencia, Spain.
7Departamento de Medicina, Universidad Valencia, 46010 Valencia, Spain.
8Departamento de Anatomía y Embriología, Universidad Valencia, 46010 Valencia, Spain.
Abstract
Patients with nonalcoholic fatty liver disease (NAFLD) may show mild cognitive impairment (MCI). The neurological functions affected remain unclear. The aims were to: (1) Characterize the neuropsychological alterations in NAFLD patients; (2) assess the prevalence of impairment of neurological functions evaluated; (3) develop a new score for sensitive and rapid MCI detection in NAFLD; (4) assess differences in MCI features between patients with nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH); and (5) compare neuropsychological alterations in NAFLD patients with cirrhotic patients with MCI. Fifty-nine NAFLD patients and 53 controls performed psychometric tests assessing different neurological functions: PHES (Psychometric Hepatic Encephalopathy Score) battery, d2, Stroop, Oral SDMT (Symbol Digit Modalities Test), Digit Span, number-letter test, and bimanual and visual-motor coordination tests. NAFLD patients show impairment in attention, mental concentration, psychomotor speed, cognitive flexibility, inhibitory mental control, and working memory. We developed a new, rapid, and sensitive score based on the most affected parameters in NAFLD patients, unveiling that 32% of NAFLD show MCI. Prevalence was similar in NAFL (36%) or NASH (27%) patients, but lower in NAFLD than in cirrhosis (65%). MCI prevalence is significant in NAFLD patients. Psychometric testing is warranted in these patients to unveil MCI and take appropriate measures to reverse and prevent its progression.