Abstract
Early Primary Biliary Cholangitis is Characterised by Brain Abnormalities on Cerebral Magnetic Resonance Imaging
Highlights
Patients with the autoimmune cholestatic liver disease primary biliary cholangitis [formerly primary biliary cirrhosis (PBC)] frequently exhibit both central nervous system (CNS) symptoms and neurophysiological and functional CNS abnormality
This is the first study to be performed in this precirrhotic patient population, and we have highlighted that neuroimaging changes are present at a much earlier stage than previously demonstrated
The neuroimaging abnormalities suggest that the brain changes seen in PBC occur early in the pathological process, even before significant liver damage has occurred
Summary
Patients with the autoimmune cholestatic liver disease primary biliary cholangitis [formerly primary biliary cirrhosis (PBC)] frequently exhibit both central nervous system (CNS) symptoms and neurophysiological and functional CNS abnormality. Recent data from the large UK-PBC patient cohort have suggested that the severity of both fatigue and cognitive symptoms post-transplant in PBC is similar to that seen in the un-transplanted population, raising the possibility that the process responsible for CNS abnormality is not reversed by transplantation.[8] Prospective studies, albeit in smaller patient numbers, have confirmed ongoing fatigue in post-transplant patients, with a severity similar to that seen in the un-transplanted PBC population.[9] The apparent lack of change in CNS symptomology in precirrhotic PBC following liver transplantation highlights the need for improved therapy earlier in the disease course to change its natural history
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