Neuroimaging Findings in Chronic Hepatitis C Virus Infection: Correlation with Neurocognitive and Neuropsychiatric Manifestations, 2020, Monaco et al

Andy · Apr 11, 2020

Chronic hepatitis C virus (HCV) infection is commonly associated with neurocognitive dysfunction, altered neuropsychological performance and neuropsychiatric symptoms. Quantifiable neuropsychological changes in sustained attention, working memory, executive function, verbal learning and recall are the hallmark of HCV-associated neurocognitive disorder (HCV-AND). This constellation is at variance with the neuropsychological complex that is seen in minimal hepatic encephalopathy, which is typified by an array of alterations in psychomotor speed, selective attention and visuo-constructive function. Noncognitive symptoms, including sleep disturbances, depression, anxiety and fatigue, which are less easily quantifiable, are frequently encountered and can dominate the clinical picture and the clinical course of patients with chronic HCV infection. More recently, an increased vulnerability to Parkinson’s disease among HCV-infected patients has also been reported.

The degree to which neurocognitive and neuropsychiatric changes are due to HCV replication within brain tissues or HCV-triggered peripheral immune activation remain to be determined. Without absolute evidence that clearly exonerates or indicts HCV, our understanding of the so-called “HCV brain syndrome”, relies primarily on clinical and neuropsychological assessments, although other comorbidities and substance abuse may impact on neurocognitive function, thus confounding an appropriate recognition. In recent years, a number of functional and structural brain imaging studies have been of help in recognizing possible biological markers of HCV-AND, thus providing a rationale for guiding and justifying antiviral therapy in selected cases. Here, we review clinical, neuroradiological, and therapeutic responses to interferon-based and interferon-free regimens in HCV-related cognitive and neuropsychiatric disorder.
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Open access, https://www.mdpi.com/1422-0067/21/7/2478/htm

Sid · Apr 11, 2020

Interesting topic but uninformative abstract.

Colin · Jan 6, 2021

Sid said: ↑

Interesting topic but uninformative abstract.
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4. Summary and Perspectives
HCV-brain syndrome presents as a prominent derangement of attention and executive functions,
associated with neuropsychiatric symptoms. In accordance with this presentation, imaging studies show
a prevalent involvement of frontal cortico-striatal structures and their connections, systems that regulate
the interactions between emotional and motivation regulation, executive and motor functions [82].
At variance with metabolic and hepatic encephalopathy, a direct involvement of the brain is
observed as an inflammatory reaction in these structures. Uncertainty still remains over the clinical
significance of this inflammation, with inconsistent findings of either a noxious or protective effect on
cognition in different studies.
Consistent with current hypotheses of brain circuitry, an altered function is also observed in distant
structures, related to the frontal cortico-striatal network, in the absence of inflammatory findings.
Scarce evidence is available on the reversibility of imaging alterations after treatment, and their
potential use as a biomarker to consider treatment initiation.
HCV-AND is a common complication in HCV-infected subjects and is a leading determinant of
quality of life, although it is often underrecognized due to its subtlety. As effective and well-tolerated
treatments are currently available, imaging biomarkers could assist clinicians in the evaluation of the
cognitive involvement in HCV.
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That bit's a bit more informative.

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Neuroimaging Findings in Chronic Hepatitis C Virus Infection: Correlation with Neurocognitive and Neuropsychiatric Manifestations, 2020, Monaco et al

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Neuroimaging Findings in Chronic Hepatitis C Virus Infection: Correlation with Neurocognitive and Neuropsychiatric Manifestations, 2020, Monaco et al

Andy Committee Member

Sid Senior Member (Voting Rights)

Colin Established Member (Voting Rights)

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