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Detection of minimal hepatic encephalopathy: normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study.
J Hepatol. 2008 Sep; 49(3):346-53.JH

Abstract

BACKGROUND/AIMS

Psychometric Hepatic Encephalopathy Score (PHES) and EEG are used to detect minimal hepatic encephalopathy (MHE). We aimed at standardizing PHES in Italy and comparing Italian, German and Spanish norms in EEG characterized cirrhotic patients.

METHODS

PHES was standardized on 228 normal individuals. Repeatability was studied in 128 individuals. One hundred patients with liver cirrhosis underwent EEG and PHES which was computed on the Spanish, German and the Italian norms.

RESULTS

Age and education levels were predictors of psychometric tests; therefore, adjusted Z scores were calculated. Practice effect (p<0.01) was detected. In the patients, the Italian norms were closer to the Spanish norms (difference -0.14+/-1.32, p=0.29) than to the Germans ones (difference 1.97+/-2.07, p<0.001). The PHES calculated on the Italian norms was correlated with the EEG mean dominant frequency more closely than the ones calculated on the German and Spanish norms (r=0.38, r=0.31, r=0.33, respectively -p<0.01). The detection of MHE on the basis of PHES and EEG showed limited agreement (73%, Cohen's K=0.32).

CONCLUSIONS

(i) Valid norms for PHES were produced, (ii) clues for the use of common norms in Latin Countries were found, (iii) different findings between PHES and EEG possibly reflect various features of MHE.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, Cirmanmec, University of Padua, Via Giustiniani, 2, 35128 Padua, Italy. piero.amodio@unipd.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

18602716

Citation

Amodio, Piero, et al. "Detection of Minimal Hepatic Encephalopathy: Normalization and Optimization of the Psychometric Hepatic Encephalopathy Score. a Neuropsychological and Quantified EEG Study." Journal of Hepatology, vol. 49, no. 3, 2008, pp. 346-53.
Amodio P, Campagna F, Olianas S, et al. Detection of minimal hepatic encephalopathy: normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study. J Hepatol. 2008;49(3):346-53.
Amodio, P., Campagna, F., Olianas, S., Iannizzi, P., Mapelli, D., Penzo, M., Angeli, P., & Gatta, A. (2008). Detection of minimal hepatic encephalopathy: normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study. Journal of Hepatology, 49(3), 346-53. https://doi.org/10.1016/j.jhep.2008.04.022
Amodio P, et al. Detection of Minimal Hepatic Encephalopathy: Normalization and Optimization of the Psychometric Hepatic Encephalopathy Score. a Neuropsychological and Quantified EEG Study. J Hepatol. 2008;49(3):346-53. PubMed PMID: 18602716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of minimal hepatic encephalopathy: normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study. AU - Amodio,Piero, AU - Campagna,Francesca, AU - Olianas,Stefania, AU - Iannizzi,Pamela, AU - Mapelli,Daniela, AU - Penzo,Marco, AU - Angeli,Paolo, AU - Gatta,Angelo, Y1 - 2008/06/02/ PY - 2007/11/19/received PY - 2008/03/28/revised PY - 2008/04/22/accepted PY - 2008/7/8/pubmed PY - 2008/12/17/medline PY - 2008/7/8/entrez SP - 346 EP - 53 JF - Journal of hepatology JO - J Hepatol VL - 49 IS - 3 N2 - BACKGROUND/AIMS: Psychometric Hepatic Encephalopathy Score (PHES) and EEG are used to detect minimal hepatic encephalopathy (MHE). We aimed at standardizing PHES in Italy and comparing Italian, German and Spanish norms in EEG characterized cirrhotic patients. METHODS: PHES was standardized on 228 normal individuals. Repeatability was studied in 128 individuals. One hundred patients with liver cirrhosis underwent EEG and PHES which was computed on the Spanish, German and the Italian norms. RESULTS: Age and education levels were predictors of psychometric tests; therefore, adjusted Z scores were calculated. Practice effect (p<0.01) was detected. In the patients, the Italian norms were closer to the Spanish norms (difference -0.14+/-1.32, p=0.29) than to the Germans ones (difference 1.97+/-2.07, p<0.001). The PHES calculated on the Italian norms was correlated with the EEG mean dominant frequency more closely than the ones calculated on the German and Spanish norms (r=0.38, r=0.31, r=0.33, respectively -p<0.01). The detection of MHE on the basis of PHES and EEG showed limited agreement (73%, Cohen's K=0.32). CONCLUSIONS: (i) Valid norms for PHES were produced, (ii) clues for the use of common norms in Latin Countries were found, (iii) different findings between PHES and EEG possibly reflect various features of MHE. SN - 0168-8278 UR - https://www.unboundmedicine.com/medline/citation/18602716/Detection_of_minimal_hepatic_encephalopathy:_normalization_and_optimization_of_the_Psychometric_Hepatic_Encephalopathy_Score__A_neuropsychological_and_quantified_EEG_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8278(08)00352-8 DB - PRIME DP - Unbound Medicine ER -