Elevated cerebral lactate: Implications in the pathogenesis of hepatic encephalopathy

Metab Brain Dis. 2014 Dec;29(4):919-25. doi: 10.1007/s11011-014-9573-9. Epub 2014 Jun 11.


Hepatic encephalopathy (HE), a complex neuropsychiatric syndrome, is a frequent complication of liver failure/disease. Increased concentrations of lactate are commonly observed in HE patients, in the systemic circulation, but also in the brain. Traditionally, increased cerebral lactate is considered a marker of energy failure/impairment however alterations in lactate homeostasis may also lead to a rise in brain lactate and result in neuronal dysfunction. The latter may involve the development of brain edema. This review will target the significance of increased cerebral lactate in the pathogenesis of HE.

Publication types

  • Review

MeSH terms

  • Ammonia / metabolism
  • Animals
  • Brain / metabolism*
  • Brain Edema / metabolism
  • Citric Acid Cycle
  • Dichloroacetic Acid / therapeutic use
  • Drug Evaluation, Preclinical
  • Hepatic Encephalopathy / drug therapy
  • Hepatic Encephalopathy / etiology*
  • Hepatic Encephalopathy / metabolism
  • Homeostasis
  • Humans
  • L-Lactate Dehydrogenase / physiology
  • Lactic Acid / metabolism*
  • Liver Diseases / complications
  • Liver Diseases / metabolism
  • Pyruvate Dehydrogenase Complex / metabolism


  • Pyruvate Dehydrogenase Complex
  • Lactic Acid
  • Ammonia
  • Dichloroacetic Acid
  • L-Lactate Dehydrogenase