Abstract #2528

J-edited Cerebral MR Spectroscopy in Patients with Hepatic Encephalopathy

Helge Jörn Zöllner^1,2, Georg Oeltzschner^3,4, Markus Butz¹, Markus S. Jördens⁵, Nur-Deniz Füllenbach⁵, Dieter Häussinger⁵, Hans-Jörg Wittsack², and Alfons Schnitzler¹

¹Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany, ²Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany, ³Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁴F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, ⁵Department of Gastroenterology, Hepatology and Infectiology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

Hepatic encephalopathy (HE) associated with elevated brain ammonia levels. The detoxification of ammonia leads to regionally selective alterations in several brain metabolites. The present study investigates these neurotransmitter changes in HE patients in the GABAergic and glutamatergic system. Using MEGA-PRESS, MR spectroscopy was performed in cerebellum, thalamus, and motor cortex. Preliminary results unravel increased GABA levels accompanied by elevated glutamine and reduced myo-Inositol in the cerebellum, but an absence of GABA level changes in the two other regions. These initial findings may lead to further explanation of cognitive and motor deficits in HE, but need to be substantiated further.

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