Auditory and visual P300 event-related potentials to detect minimal hepatic encephalopathy
Por:
Daniel Santana-Vargas, Angel, Higuera-de la Tijera, Fatima, Luis Perez-Hernandez, Jose
Publicada:
1 ene 2022
Resumen:
Introduction: the diagnosis of minimal hepatic encephalopathy (MHE)
requires psychometric tests, although new methods are needed since their
sensitivity, specificity, and accuracy are low. The P300 event-related
potential (ERP) is obtained by auditory and visual stimuli, although
only the auditory P300 has been used to detect MHE. This study aimed to
compare the diagnostic features of auditory and visual P300 to detect
MHE.
Materials and methods: sixty patients with liver cirrhosis and
thirty-five healthy controls completed the Psychometric Hepatic
Encephalopathy Score (PHES), the critical flicker frequency (CFF), and
auditory and visual P300 tests. MHE was diagnosed if PHES and CFF scores
were abnormal.
Results: fifty-three cirrhotic patients (aged 54.5 +/- 8.6 years)
completed all tests. Abnormal scores were obtained for PHES (49.1 %)
and CFF (67.9 %). The proportion of MHE was 21.4 %. The area under the
receiver operating (ROC) curves (AUROC) for auditory P300 was better
than for visual P300 for distinguishing MHE from controls (AUROC: 0.792
vs 0.725; p < 0.005 for both; accuracy: 73.8 % vs 70.2 %; sensitivity:
72.2 % for both; specificity: 74.2 vs 69.7, respectively). Among
cirrhotic patients, only auditory P300 was useful to detect MHE (AUROC:
0.723; p < 0.05; 77.4 % accuracy; 61.1 % sensitivity, and 81.8 %
specificity).
Conclusions: auditory P300 sensitivity, specificity, and accuracy were
similar to those of CFF. Our results showed that only auditory P300 is
useful to differentiate patients with MHE, although both modalities,
auditory and visual, differentiated patients with cirrhosis from
controls. Thus, we consider that visual P300 is not suitable for
detecting MHE.
Filiaciones:
Daniel Santana-Vargas, Angel:
Hosp Gen Mexico Dr Eduardo Liceaga, Res Dept, Mexico City, DF, Mexico
Univ Nacl Autonoma Mexico, Fac Med, Sleep Disorders Clin, Mexico City, DF, Mexico
Higuera-de la Tijera, Fatima:
Hosp Gen Mexico Dr Eduardo Liceaga, Gastroenterol Serv, Mexico City, DF, Mexico
Luis Perez-Hernandez, Jose:
Hosp Gen Mexico Dr Eduardo Liceaga, Gastroenterol Serv, Mexico City, DF, Mexico
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