VISUAL-ATTENTION IN CIRRHOTIC-PATIENTS - A STUDY ON COVERT VISUAL-ATTENTION ORIENTING

Attentional dysfunction, which influences overall cognitive productivi ty, is not well characterized in cirrhotic patients. The aim of this s tudy was to clarify the features of covert visual attention orienting in cirrhotics without overt hepatic encephalopathy. One hundred consec utive cirrhotic patients and 40 controls were enrolled. Visual covert attention orienting was assessed by the Posner test, which evaluates t he effect of a cue on visual reaction times. Patients were characteriz ed by the number connection test (NCT) and electroencephalographic (EE G) spectral analysis. The severity of liver disease was graded using s tandard laboratory parameters and the Child-Pugh's classification. Fif ty-five psychometric and EEG evaluations were performed in the follow- up of 17 patients to assess the relationship between the variations of psychometric and neurophysiological findings. NCT and quantified-EEG parameters (altered in 19% and 40% of cirrhotic patients, respectively ) were linked to each other and to the severity of liver disease. The Posner test showed a delay of visual reaction times in class B-C cirrh otic patients. Reaction times were correlated with ammonia and EEG par ameters. The effect of the cue was higher in cirrhotic patients than i n controls, particularly in the invalid position. This study suggests that cirrhotic patients have a reduced activity rate and reduced capac ity to disengage attention previously focused on a cue. Such alteratio ns are linked to NCT and EEG findings.