The neuroprotective power of artificial liver therapy: reversing cognitive impairment in minimal hepatic encephalopathy

Alteration of functional connectivity in brain regions is one of the potential neuropathological mechanisms underlying cognitive impairment in patients with minimal hepatic encephalopathy (MHE). Artificial liver therapy has been shown to improve cognitive impairment in patients, suggesting a potential neuroprotective effect on the brain. This study investigates the impact of artificial liver therapy (AL) on cognitive impairment in patients with minimal hepatic encephalopathy (MHE) by examining alterations in brain functional connectivity. Resting-state functional magnetic resonance imaging (fMRI) data was collected from healthy controls and MHE patients before and after therapy. The MHE_post−AL group showed improved memory, reaction time, and executive function compared to the MHE_pre−AL group. Functional connectivity analysis revealed increased connectivity in specific brain regions in the MHE_pre−AL group compared to healthy controls, with subsequent decreased connectivity after therapy. Lower MoCA scores, higher blood ammonia levels, and lower cholinesterase levels were associated with higher functional connectivity in the MHE_pre−AL group. The study suggests that artificial liver therapy improves cognitive impairment in MHE patients, with changes in blood biochemistry mediating the link between functional connectivity and cognitive function. Correcting blood biochemistry levels may reverse abnormal brain connectivity and enhance cognitive function in MHE patients.