DYNAMICS OF COGNITIVE BRAIN-DYSFUNCTION IN PATIENTS WITH CIRRHOTIC LIVER-DISEASE - AN EVENT-RELATED P300 POTENTIAL PERSPECTIVE

The dynamics of cognitive brain functions of 104 patients with both ch ronic non-cirrhotic (NC) and cirrhotic liver disease (C: C1, non-encep halopathic; C2, encephalopathic) were investigated by means of visual P300 potentials elicited in both the paradigms of transient (PI) and s elective attention (PII). Conventional PVEPs, psychometric tests and q uantitative liver function tests were also performed. As compared to b oth an age-matched control group (N) and the non-cirrhotic patients (N C), the N250 and P300 latencies of the cirrhotics (C) were equally pro longed in both P300 paradigms (P = 0.0001). By contrast, the P300 ampl itudes were not different between the patient groups in either P300 pa radigm. In the cirrhotics, however, the P300 amplitude differences bet ween PII and PI (+3.7+2.8 mu V, mean +/- S.D.) were significantly (P < 0.01) smaller than in the non-cirrhotics (+ 7.5 +/- 5.2 mu V) reflect ing disturbances in the dynamics of visual attention. Interestingly, t hese P300 amplitude differences between both paradigms were positively correlated (r = 0.35; P = 0.005) with hepatic metabolic capacity, but not with liver blood flow (r = 0.23; P > 0.05). The diagnostic effica cy of the visual P300 in PI (sensitivity, 48%; specificity, 100%) was lower than that of the visual P300 in PII (79%; 100%) and that of the psychometric tests (63%; 94%), but it remained superior to that of the PVEPs (29%; 97%). It is concluded that in patients with cirrhotic liv er disease visual P300 potentials can even reveal the dynamics of mino r cognitive brain dysfunction and may also provide interesting pathoph ysiological information.