Abstract
BackgroundMinimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. Psychometric Hepatic Encephalopathy Score (PHES) is a gold standard test for the early diagnosis of MHE in cirrhotic patients. The aim of this study was to standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients.MethodsThis was a prospective, multicentric study from 1 December 2018 to 31 July 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the number connection test-A, number connection test-B, serial dotting test, line tracing test were expressed in seconds and those of the digit symbol test in points.ResultsA total of 102 healthy volunteers (54 men, 48 women) and 50 cirrhotic patients (29 men, 31 women) were included. The mean age was 38.1 ± 12.55 years in healthy volunteers and 49.3 ± 15.6 years in cirrhotic patients. The mean years of education level was 11.63 ± 4.20 years in healthy volunteers and 9.62 ± 3.9 years in cirrhotic patients. The PHES of the healthy volunteer group was − 0.08 ± 1.28 and the cut-off between normal and pathological values was set at − 3 points. PHES of the cirrhotic patients was − 7.66 ± 5.62 points and significantly lower than that of volunteers (p < 0.001). Prevalence of MHE was 74% among cirrhotic patients. Age and education level were associated with MHE.ConclusionPHES cut-off value in Cameroonians is − 3, with MHE prevalence of 74% among cirrhotic patients.
Highlights
Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests
Age and education were significantly correlated with all test performance except for Line tracing Test (LTT) with age (Table 2)
The results of Number connection Test-A (NCT-A), Number connection TestB (NCT-B), Serial Dotting Test (SDT), Digit Symbol Test (DST), LTT and Psychometric Hepatic Encephalopathy Score (PHES) score were consistent with the results reported elsewhere revealing the influence of age and level of education on psychometric tests [10,11,12]
Summary
Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. The aim of this study was to standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients. Psychometric Hepatic Encephalopathy Score (PHES) is the score of the porto-systemic encephalopathy (PSE) battery, which is made up of five (5) psychometrical tests It is recommended as a first line diagnostic tool for MHE [1]. These include Digit Symbol Test (DST), Number connection Test-A (NCT-A), Number connection TestB (NCT-B), Serial Dotting Test (SDT), Line tracing Test (LTT). This study aimed at standardising the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among Cameroonian patients with liver cirrhosis
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