Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy

Agnieszka Stawicka, Jerzy Jaroszewicz, Justyna Zbrzeźniak, Natalia Sołowianowicz, Aleksandra Woszczenko, Magdalena Świderska and Robert Flisiak
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Agnieszka Stawicka: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
Jerzy Jaroszewicz: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
Justyna Zbrzeźniak: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
Natalia Sołowianowicz: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
Aleksandra Woszczenko: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
Magdalena Świderska: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
Robert Flisiak: Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland

IJERPH, 2020, vol. 17, issue 10, 1-8

Abstract: Background : Minimal hepatic encephalopathy (MHE) refers to a number of neuropsychiatric and neurophysiological disorders in patients with cirrhosis who do not show abnormalities on physical examination or in clinical tests. The aim of this study was to determine the prevalence, risk factors, and predictive value of minimal hepatic encephalopathy and the usefulness of the inhibitory control test (ICT) in the diagnosis. Methods : Seventy patients (mean age 53 years, range 24−77) with liver cirrhosis were enrolled in the study. MHE was diagnosed based on PHES (psychometric hepatic encephalopathy score) and ICT. PHES and ICT were validated in a group of 56 control subjects. Results : Minimal hepatic encephalopathy was diagnosed using PHES in 21 patients (30%). ICT diagnosed MHE in 30 patients (42%), and the test had a sensitivity of 65% and a specificity of 57% compared to PHES. The ICT score (lures/target accuracy rate) correlated with the age of subjects (R = 0.35, p = 0.002) and only slightly with education (education in years R = −0.22, p = 0.06). MHE diagnosed with PHES or ICT was associated with a significantly higher model of end-stage liver disease (MELD) score in the follow-up. MHE diagnosed with ICT was correlated with a significantly higher incidence of symptoms of decompensated cirrhosis ( p = 0.02) in the follow-up. Conclusions : ICT had moderate sensitivity and specificity in diagnosing MHE compared to PHES. Importantly, MHE detected with PHES or ICT was associated with poorer survival and a more severe progression of the disease.

Keywords: minimal hepatic encephalopathy; MHE; liver encephalopathy; liver cirrhosis; inhibitory control test; ICT (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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