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Abstract #4269

Biochemical, Anatomical and Neuropsychological Correlates in Hepatic Encephalopathy

Aparna Singhal1, Charles Hinkin2, Nagarajan Rajakumar1, Rajesh Kumar3, Amir Huda1,4, Steven-Huy B. Han5, Virginia Elderkin-Thompson2, James W. Sayre1,6, Rakesh K. Gupta7, Michael Albert Thomas1

1Radiology, UCLA, Los Angeles, CA, USA; 2Psychiatry & Biobehavioural Sciences, UCLA, Los Angeles, CA, USA; 3Neurobiology, UCLA, Los Angeles, CA, USA; 4Physics, California State University, Fresno, CA, USA; 5Medicine, UCLA, Los Angeles, CA, USA; 6Public Health- Biostatiscs, UCLA, Los Angeles, CA, USA; 7Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India

The frontal and occipital white/gray matter regions were investigated in 34 minimal hepatic encephalopathy (MHE) patients and 30 controls using single-voxel-based 2D L-COSY. Globus pallidal signal-intensities were calculated and neuropsychological tests (NPT) were performed on the same day. There was significant elevation of combined glutamate and glutamine to creatine ratios, as well as reduction in choline, taurine and myo-inositol compared to controls. 2D MRS ratios including taurine correlated strongly with NPTs indicating their role in the pathogenesis and mICh/Cr_d ratio gives the best diagnostic predictability in differentiating MHE patients from controls compared to NPTs or MRI alone.