Brain Function and Chemistry Analysis in Chronic Hepatic Encephalopathy Patients

Hepatic encephalopathy (HE) is a common condition that affects the brain and behavior, often seen in people with liver diseases like cirrhosis. In the UK, cirrhosis is responsible for 4000 deaths annually, and around 500,000 people are believed to have chronic hepatitis C, which can lead to cirrhosis in up to 20% of cases over 20 years. Unfortunately, monitoring this condition objectively has been challenging, and there's no universally accepted standard test for its diagnosis and monitoring. This study aims to address these challenges by using a novel approach that combines magnetic resonance imaging (MRI) sequences to examine the effects of HE on the brain in patients with cirrhosis. In this study, 50 patients will undergo blood tests, a 1-hour MRI brain scan, and psychometric testing, which includes both computer-based and paper-based tests. After these initial assessments, patients will receive L-ornithine L-aspartate (LOLA) treatment orally for 4 weeks. Following this treatment period, they will repeat the blood tests, MRI, and psychometric tests. The study's primary goal is to observe changes in the brain's size, function, and chemistry before and after the anti-encephalopathy treatment with LOLA. By correlating the MRI data with the results of the psychometric testing, researchers hope to determine the sensitivity of the MR techniques in assessing HE and the brain's response to therapy.