Attention deficits in minimal hepatic encephalopathy

Minimal hepatic encephalopathy (HE) is characterized by a decrease of psych omotor speed, and deficits in visual perception, visuo-spatial orientation. and visuo-constructive abilities. Attention deficits have also been propos ed to be part of the syndrome. Several attempts were made in the past to el aborate suitable psychometric means for the assessment of minimal HE. Howev er, there is still no "gold standard" for the diagnosis of minimal HE. We r ecently evaluated the so called "PSE-Test" for the assessment of minimal HE , a test battery which does not include a test predominantly aimed at the a ssessment of attention. We therefore presented a battery of attention tests in addition to the PSE-Test to a group of cirrhotics without clinical sign s of HE compared to a healthy control group matched for age and education t o determine whether the addition of special attention tests would increase the diagnostic sensitivity of the PSE-Test. It was shown that the patients with a pathological PSE-Test result differed significantly from controls in all attention tests applied, while the patients with normal PSE-Test resul ts achieved attention test results similar to that of the controls. Thus, t he PSE-Test results represent attention deficits as well as deficits in mot or skills, visuo-spatial orientation, and visual construction.