Chronic liver disease adversely affects neurocognitive functioning. These cognitive and mental status changes can range from subclinical and frequently undiagnosed impairments, known as covert hepatic encephalopathy (HE), to overt HE, with requires hospitalization and increases mortality. Efficient and practical screening tests are needed to detect early cognitive alterations, to avoid the progression to advanced grades of HE. Objective: To identify patients at high risk of developing overt EH within a year, using a battery of online cognitive tests.
190 cirrhotic patients from CHUM Hepatology clinic will be recruited for a prospective 1-year longitudinal study and will perform the CBS cognitive assessment at baseline. Cambridge Brain Sciences (CBS), an online platform adapted for research, offers a 45-minute online self-assessment that evaluates 4 cognitive domains (memory, reasoning, concentration and verbal ability). Scores are compared to a large age and gender-matched population database. Patients will be followed up for 1 year with phone calls every 3 months and medical records will be checked to identify HE-related hospitalizations and mortality. Statistical analysis will be performed to study the correlation between screening test results and patient outcomes.
To date, 14 participants (78% men, mean age 62.42 ± 7.25) have been included. Results show that cirrhotic patients scored below average in more than 90% of cognitive tasks performed, compared to the normative database.
The expected results can provide important information for identifying patients at high risk of developing overt HE within 1 year, which can propose prophylaxis, early treatment, prevention of episodes and promote a great impact on the patient's quality of life, cost of treatments and decrease in mortality.