AUTHOR=Lin Shiwei , Guo Zheng , Chen Shengli , Lin Xiaoshan , Ye Min , Qiu Yingwei 

TITLE=Progressive Brain Structural Impairment Assessed via Network and Causal Analysis in Patients With Hepatitis B Virus-Related Cirrhosis

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.849571

DOI=10.3389/fneur.2022.849571

ISSN=1664-2295

ABSTRACT=<sec><title>Objectives</title><p>This research amid to elucidate the disease stage-specific spatial patterns and the probable sequences of gray matter (GM) deterioration as well as the causal relationship among structural network components in hepatitis B virus-related cirrhosis (HBV-RC) patients.</p></sec><sec><title>Methods</title><p>Totally 30 HBV-RC patients and 38 healthy controls (HC) were recruited for this study. High-resolution T1-weighted magnetic resonance imaging and psychometric hepatic encephalopathy score (PHES) were evaluated in all participants. Voxel-based morphometry (VBM), structural covariance network (SCN), and causal SCN (CaSCN) were applied to identify the disease stage-specific GM abnormalities in morphology and network, as well as their causal relationship.</p></sec><sec><title>Results</title><p>Compared to HC (0.443 ± 0.073 cm3), the thalamus swelled significantly in the no minimal hepatic encephalopathy (NMHE) stage (0.607 ± 0.154 cm3, <italic>p</italic> &lt;0.05, corrected) and further progressed and expanded to the bilateral basal ganglia, the cortices, and the cerebellum in the MHE stage (<italic>p</italic> &lt; 0.05, corrected). Furthermore, the thalamus swelling had a causal effect on other parts of cortex-basal ganglia-thalamus circuits (<italic>p</italic> &lt; 0.05, corrected), which was negatively correlated with cognitive performance (<italic>r</italic> = −0.422, <italic>p</italic> &lt; 0.05). Moreover, the thalamus-related SCN also displayed progressive deterioration as the disease advanced in HBV-RC patients (<italic>p</italic> &lt; 0.05, corrected).</p></sec><sec><title>Conclusion</title><p>Progressive deterioration of GM morphology and SCN exists in HBV-RC patients during advanced disease, displaying thalamus-related causal effects. These findings indicate that bilateral thalamus morphology as well as the thalamus-related network may serve as an <italic>in vivo</italic> biomarker for monitoring the progression of the disease in HBV-RC patients.</p></sec>