SUBCLINICAL HEPATIC-ENCEPHALOPATHY - APPL ICATION OF COMPUTER-ASSISTED PSYCHOMETRIC METHODS

Subclinical hepatic encephalopathy ist the most frequent complication of hepatic cirrhosis. Only psychometric test are able to detect these cognitive disturbances during the talent stage of the disorder. Conven tional paper and pencil tests are only partly suitable for diagnosing these neuropsychological disturbances. A new psychometric test to reco rd reaction limes and power of memory fully automatically, from testin g to interpreation, has been developed and undergone trials. With comp uter-assisted instrument it was possible to differentiate exactly betw een patients with (n = 15) and without (n = 35) subclinical hepatic en cephalopathy on the basis of the (longer) reaction times. The number o f patients with subclinical hepatic encephalopathy increased significa ntly in line with the severity of hepatic cirrhosis (Child-Pugh classi fication) in spite of the fact that there was no correlation with ammo nia levels or aetiology of cirrhosis. Patients with alcoholic cirrhosi s showed significantly poorer memory, although they achieved the same results in the reaction time tests as the rest of the group. The compu ter-assisted test agrees closely with other modern diagnostic procedur es for subclinical hepatic encephalopathy, but not with simple, less s ensitive bedside tests.