To examine the spatial distribution of gray matter abnormalities in hepatic encephalopathy (HE) and their relationships with brain network hubs, neighborhood connectivity, and disease epicenters.
Approach:
Study Design: Cross-sectional study involving 45 patients with HE and 45 healthy controls using high-resolution T1-weighted MRI.
Data Analysis: Cortical thickness and volumes were measured; group differences analyzed controlling for age, sex, and total intracranial volume. Connectome-based analyses assessed hub-related vulnerability, network-neighborhood effects, and disease epicenters.
Key Findings:
Patients with HE exhibited widespread gray matter abnormalities in the prefrontal, motor, temporal, and limbic cortices, as well as in the basal ganglia and thalamus.
Gray matter abnormalities did not align significantly with normative functional or structural hubs.
Structural neighborhood abnormalities correlated positively with cortical changes.
Functional-connectome epicenters were found in the left inferior frontal gyrus, orbitofrontal cortex, and striatum.
Structural-connectome epicenters centered on the bilateral superior frontal gyri and left inferior frontal gyrus.
Interpretation:
Gray matter abnormalities in HE are organized non-randomly and associated with prefrontal-centered disease epicenter networks.
Limitations:
Study limited to patients with specific grades of HE, excluding those with severe grades.
Cross-sectional design limits causal inferences regarding the relationship between gray matter abnormalities and HE.
Conclusion:
The study provides connectome-based insights into gray matter abnormalities in HE.
