P. Amodio et al., THE EFFECT OF FLUMAZENIL ON SUBCLINICAL PSYCHOMETRIC OR NEUROPHYSIOLOGICAL ALTERATIONS IN CIRRHOTIC-PATIENTS - A DOUBLE-BLIND PLACEBO-CONTROLLED STUDY, Clinical physiology, 17(5), 1997, pp. 533-539
It is not yet clear if benzodiazepine receptor ligands, implicated in
the pathophysiology of hepatic coma, also have a role in subclinical c
ognitive or neurophysiological alterations in cirrhotic patients. Ther
efore, we carried out a double-blind, placebo-controlled study to eval
uate the effectiveness of flumazenil, a benzodiazepine antagonist, on
brainstem auditory evoked responses and on the number connection test
in cirrhotic patients with subclinical neurophysiological or cognitive
alterations. Thirteen cirrhotic subjects with subclinical neurophysio
logical or cognitive alterations were studied. A total of 3 mg of flum
azenil or saline was infused intravenously. Before and after the infus
ion, the number connection test was administered and brainstem auditor
y evoked responses recorded. After 72 h, patients were crossed over. F
lumazenil did not influence brainstem auditory evoked responses or the
number connection test. A screening test for benzodiazepines was nega
tive in all subjects. We conclude that benzodiazepine receptor ligands
have a negligible role, if any, in the pathophysiology of subclinical
neurophysiological or cognitive alterations of cirrhotic patients.