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Inhibitory control test, critical flicker frequency, and psychometric tests in the diagnosis of minimal hepatic encephalopathy in cirrhosis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sharma, Praveen Kumar, Ajay Singh, Shweta Tyagi, Pankaj Kumar, Ashish
Description	Country affiliation: India Author Affiliation: Sharma P ( Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. drpraveen_sharma@yahoo.com)
Abstract	BACKGROUND/AIM: Minimal hepatic encephalopathy (MHE) impairs health-related quality of life and driving ability of the patient. OBJECTIVE: We assessed the utility of the inhibitory control test (ICT), critical flicker frequency (CFF), and psychometry in the diagnosis of MHE. PATIENTS AND METHODS: Consecutive patients with cirrhosis underwent number connection tests A and B (NCT-A, B), digit symbol test (DST), line tracing test (LTT), serial dot test (SDT), CFF, and ICT at baseline and after four hours. Fifty healthy subjects served as controls for the ICT test. RESULTS: Fifty patients with cirrhosis (43.4 ± 10.2 yrs, M: F 42:8) underwent psychometric tests [NCT-A (48.3 ± 17.7 vs. 42.6 ± 17.3 sec, P = 0.001), NCT-B (85.7 ± 40.1 vs. 90.2 ± 37.0 sec, P = 0.18), DST (23.5 ± 9.3 vs. 23.0 ± 8.7, P = 0.45), LTT (96.6 ± 48.2 vs. 96.8 ± 46.8 sec, P = 0.92), SDT (88.0 ± 39.5 vs. 83.4 ± 37.2 sec, P = 0.02)] at baseline and after four hours. Target accuracy of ICT was lower in patients with cirrhosis compared with controls (88.4 ± 5.6 vs. 95.6 ± 2.1, P = 0.01), whereas ICT lures were higher (18.3 ± 4.2 vs 10.2 ± 2.8, P = 0.01). Patients with cirrhosis showed a reduction in lures in the second evaluation compared with the first (18.3 ± 4.2 vs. 17.1 ± 4.3, P = 0.003) but no change in target accuracy (88.4 ± 5.6 vs. 88.4 ± 5.3, P = 0.97). Control subjects did not show any change either in lures (10.2 ± 2.8 vs. 10.3 ± 2.1, P = 0.65) or target accuracy (95.6 ± 2.1 vs. 95.5 ± 2.2, P = 0.82). The sensitivity and specificity of ICT test for the diagnosis of MHE at lure rate >16.5 was 88.5 and 56%, respectively. CFF in patients with MHE (38.4 ± 1.8 vs. 38.6 ± 1.5, P = 0.3) and non MHE (40.6 ± 2.2 vs. 40.8 ± 2.2, P = 0.6) did not show any difference after four hours as in controls (41.9 ± 2.4 vs. 42.1 ± 2.0, P = 0.3). Thirty one (31%) patients preferred psychometric tests, 57 (57%) preferred CFF and only 12 (12%) preferred ICT ( P = 0.001). CONCLUSIONS: ICT, CFF, and psychometric tests are useful tools to assess MHE, and CFF was preferred by this study cohort.
File Format	HTM / HTML
ISSN	13193767
e-ISSN	19984049
DOI	10.4103/1319-3767.105924
Journal	Saudi Journal of Gastroenterology
Issue Number	1
Volume Number	19
Language	English
Publisher	MedKnow Publication
Publisher Date	2013-01-01
Publisher Place	India
Access Restriction	Open
Subject Keyword	Discipline Gastroenterology Hepatic Encephalopathy Diagnosis Liver Cirrhosis Complications Neuropsychological Tests Psychometrics Etiology Psychology Reproducibility Of Results Retrospective Studies Severity Of Illness Index
Content Type	Text
Resource Type	Article
Subject	Gastroenterology

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Inhibitory Control Test, Critical Flicker Frequency, and Psychometric Tests in the Diagnosis of Minimal Hepatic Encephalopathy in Cirrhosis

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