PMID- 23056400
OWN - NLM
STAT- MEDLINE
DCOM- 20130503
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 10
DP  - 2012
TI  - Dynamic changes of intrinsic brain activity in cirrhotic patients after 
      transjugular intrahepatic portosystemic shunt: a resting-state FMRI study.
PG  - e46681
LID - 10.1371/journal.pone.0046681 [doi]
LID - e46681
AB  - PURPOSE: The majority of cirrhotic patients who underwent transjugular 
      intrahepatic portosystemic shunt (TIPS) experienced the first post-TIPS hepatic 
      encephalopathy (HE) episode within the first three months after TIPS insertion. 
      However, so far, little is known about the exact neuro-pathophysiological 
      mechanism of TIPS's effects on brain function. We aimed to investigate the 
      dynamics of brain function alteration of post-TIPS patients using resting-state 
      functional MRI (rs-fMRI). MATERIALS AND METHODS: Sixteen cirrhotic patients who 
      were scheduled for TIPS and 16 healthy controls were included in the rs-fMRI 
      scans. Ten patients repeated the MRI study in a median 8-day follow-up interval 
      following TIPS and seven in a median 3-month follow-up. The amplitude of low 
      frequency fluctuation (ALFF), an index reflecting the spontaneous brain activity, 
      was compared between patients before TIPS and healthy controls as well as 
      patients pre- and post-TIPS. RESULTS: Compared with healthy controls, patients 
      showed decreased ALFF in frontal and parietal regions and increased ALFF in 
      insula. Patients who underwent the median 8-day follow-up fMRI examinations 
      showed decreased ALFF in posterior cingulate cortex (PCC)/precuneus and increased 
      ALFF in anterior cingulate cortex (ACC). Of 10 patients in this group, 9 had 
      moderate to large increase rate of ALFF value (>20%, mean 49.19%) in ACC, while 
      only one patient with the smallest increase rate of ALFF value (<10%) in ACC, who 
      experienced three episodes of overt HE during the 3-month follow-up. In the 
      median 3-month follow up observation, patients displayed persistently decreased 
      ALFF in PCC, ACC and medial prefrontal cortex (MPFC), while no increased regional 
      ALFF was observed. CONCLUSION: TIPS insertion alters cirrhotic patients' ALFF 
      patterns in the resting state, which may imply different short-term and 
      moderate-term effects on cirrhotic patients, i.e., both impairment and 
      compensatory mechanism of brain functions in peri-TIPS and continuous impairment 
      of brain function 3 months following TIPS.
FAU - Qi, Rongfeng
AU  - Qi R
AD  - Department of Medical Imaging, Jinling Hospital, Clinical School of Medical 
      College, Nanjing University, Nanjing, Jiangsu, China.
FAU - Zhang, Long Jiang
AU  - Zhang LJ
FAU - Zhong, Jianhui
AU  - Zhong J
FAU - Wu, Shengyong
AU  - Wu S
FAU - Zhang, Zhiqiang
AU  - Zhang Z
FAU - Zhong, Yuan
AU  - Zhong Y
FAU - Ni, Ling
AU  - Ni L
FAU - Zheng, Gang
AU  - Zheng G
FAU - Jiao, Qing
AU  - Jiao Q
FAU - Wu, Xingjiang
AU  - Wu X
FAU - Fan, Xinxin
AU  - Fan X
FAU - Liu, Yijun
AU  - Liu Y
FAU - Lu, Guangming
AU  - Lu G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121002
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Brain/*physiology/*physiopathology
MH  - Female
MH  - Humans
MH  - Liver Cirrhosis/*surgery
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Portasystemic Shunt, Transjugular Intrahepatic/*adverse effects
PMC - PMC3462766
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2012/10/12 06:00
MHDA- 2013/05/04 06:00
PMCR- 2012/10/02
CRDT- 2012/10/12 06:00
PHST- 2012/05/24 00:00 [received]
PHST- 2012/09/02 00:00 [accepted]
PHST- 2012/10/12 06:00 [entrez]
PHST- 2012/10/12 06:00 [pubmed]
PHST- 2013/05/04 06:00 [medline]
PHST- 2012/10/02 00:00 [pmc-release]
AID - PONE-D-12-15170 [pii]
AID - 10.1371/journal.pone.0046681 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(10):e46681. doi: 10.1371/journal.pone.0046681. Epub 2012 Oct 2.