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Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy.
J Hepatol. 2007 Jul; 47(1):67-73.JH

Abstract

BACKGROUND/AIMS

Minimal hepatic encephalopathy (MHE) is associated with poorer quality of life and increased work disability. Diagnosis requires cumbersome psychometric and neurophysiological tests. We evaluated critical flicker frequency (CFF) to diagnose MHE.

METHODS

156 cirrhotic patients (age 41+/-12.5 yr) without overt encephalopathy (Child A 63, Child B 56, Child C 37) were evaluated by psychometric (number connection tests A, B or figure connection tests A, B), P300 auditory event related potential (ERP) and CFF. MHE was diagnosed by abnormal psychometric and/or P300 auditory event related potential.

RESULTS

Prevalence of MHE was 53% with 27 (43%) in Child's A, 33 (59%) in Child's B and 23 (62%) in Child's C cirrhosis (p=NS). Of 83 patients, 72 (87%) had abnormal psychometry, 64 (77%) had abnormal P300 auditory event related potential (ERP) (380.6+/-28.8 ms) and in 66 (80%) CFF was below 39 Hz. 60 (83%) patients with abnormal psychometry and 51 (80%) with abnormal P300 auditory event related potential had CFF below 39 Hz. CFF sensitivity (96%), specificity (77%) and positive predictive value (68%), negative predictive value (98%) and diagnosis accuracy was 83.3% when compared to patients with both abnormal psychometry and P300ERP.

CONCLUSIONS

Critical flicker frequency is a simple, reliable and accurate test without any age or literacy dependence for the diagnosis of MHE.

Authors+Show Affiliations

Department of Gastroenterology, Room 203, Academic Block, G.B. Pant Hospital, New Delhi 110002, India.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

17459511

Citation

Sharma, P, et al. "Critical Flicker Frequency: Diagnostic Tool for Minimal Hepatic Encephalopathy." Journal of Hepatology, vol. 47, no. 1, 2007, pp. 67-73.
Sharma P, Sharma BC, Puri V, et al. Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy. J Hepatol. 2007;47(1):67-73.
Sharma, P., Sharma, B. C., Puri, V., & Sarin, S. K. (2007). Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy. Journal of Hepatology, 47(1), 67-73.
Sharma P, et al. Critical Flicker Frequency: Diagnostic Tool for Minimal Hepatic Encephalopathy. J Hepatol. 2007;47(1):67-73. PubMed PMID: 17459511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy. AU - Sharma,P, AU - Sharma,B C, AU - Puri,V, AU - Sarin,S K, Y1 - 2007/04/09/ PY - 2006/09/12/received PY - 2007/01/18/revised PY - 2007/02/20/accepted PY - 2007/4/27/pubmed PY - 2007/9/14/medline PY - 2007/4/27/entrez SP - 67 EP - 73 JF - Journal of hepatology JO - J. Hepatol. VL - 47 IS - 1 N2 - BACKGROUND/AIMS: Minimal hepatic encephalopathy (MHE) is associated with poorer quality of life and increased work disability. Diagnosis requires cumbersome psychometric and neurophysiological tests. We evaluated critical flicker frequency (CFF) to diagnose MHE. METHODS: 156 cirrhotic patients (age 41+/-12.5 yr) without overt encephalopathy (Child A 63, Child B 56, Child C 37) were evaluated by psychometric (number connection tests A, B or figure connection tests A, B), P300 auditory event related potential (ERP) and CFF. MHE was diagnosed by abnormal psychometric and/or P300 auditory event related potential. RESULTS: Prevalence of MHE was 53% with 27 (43%) in Child's A, 33 (59%) in Child's B and 23 (62%) in Child's C cirrhosis (p=NS). Of 83 patients, 72 (87%) had abnormal psychometry, 64 (77%) had abnormal P300 auditory event related potential (ERP) (380.6+/-28.8 ms) and in 66 (80%) CFF was below 39 Hz. 60 (83%) patients with abnormal psychometry and 51 (80%) with abnormal P300 auditory event related potential had CFF below 39 Hz. CFF sensitivity (96%), specificity (77%) and positive predictive value (68%), negative predictive value (98%) and diagnosis accuracy was 83.3% when compared to patients with both abnormal psychometry and P300ERP. CONCLUSIONS: Critical flicker frequency is a simple, reliable and accurate test without any age or literacy dependence for the diagnosis of MHE. SN - 0168-8278 UR - https://www.unboundmedicine.com/medline/citation/17459511/Critical_flicker_frequency:_diagnostic_tool_for_minimal_hepatic_encephalopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8278(07)00145-6 DB - PRIME DP - Unbound Medicine ER -