Classification of cirrhotic patients with or without minimal hepatic encephalopathy and healthy subjects using resting-state attention-related network analysis

PLoS One. 2014 Mar 19;9(3):e89684. doi: 10.1371/journal.pone.0089684. eCollection 2014.

Abstract

Background: Attention deficit is an early and key characteristic of minimal hepatic encephalopathy (MHE) and has been used as indicator for MHE detection. The aim of this study is to classify the cirrhotic patients with or without MHE (NMHE) and healthy controls (HC) using the resting-state attention-related brain network analysis.

Methods and findings: Resting-state fMRI was administrated to 20 MHE patients, 21 NMHE patients, and 17 HCs. Three attention-related networks, including dorsal attention network (DAN), ventral attention network (VAN), and default mode network (DMN), were obtained by independent component analysis. One-way analysis of covariance was performed to determine the regions of interest (ROIs) showing significant functional connectivity (FC) change. With FC strength of ROIs as indicators, Linear Discriminant Analysis (LDA) was conducted to differentiate MHE from HC or NMHE. Across three groups, significant FC differences were found within DAN (left superior/inferior parietal lobule and right inferior parietal lobule), VAN (right superior parietal lobule), and DMN (bilateral posterior cingulate gyrus and precuneus, and left inferior parietal lobule). With FC strength of ROIs from three networks as indicators, LDA yielded 94.6% classification accuracy between MHE and HC (100% sensitivity and 88.2% specificity) and 85.4% classification accuracy between MHE and NMHE (90.0% sensitivity and 81.0% specificity).

Conclusions: Our results suggest that the resting-state attention-related brain network analysis can be useful in classification of subjects with MHE, NMHE, and HC and may provide a new insight into MHE detection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention*
  • Brain / pathology
  • Brain / physiopathology*
  • Brain Mapping
  • Case-Control Studies
  • Discriminant Analysis
  • Female
  • Hepatic Encephalopathy / complications
  • Hepatic Encephalopathy / diagnosis*
  • Hepatic Encephalopathy / pathology
  • Hepatic Encephalopathy / physiopathology
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nerve Net / pathology
  • Nerve Net / physiopathology*
  • Rest
  • Sensitivity and Specificity

Grant support

This work was supported by grants from the National Basic Research Program of China (973 Program: No.2013CB733800, No.2013CB733803), National Natural Science Foundation of China (No. 30910103905), and Scientific Research Foundation of Graduate School of Southeast University (No. YBJJ1243). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.