Despite the abnormal structural findings in cirrhotic patients with MHE, previous studies have only focused on regional structural changes in cirrhosis and did not consider brain network-level architecture. Recent progress in structural MRI analysis has facilitated the development of a human brain structural network model that is based on statistical correlations of morphological descriptors, including the thickness of the cortex or regional gray matter volume (RGMV). We investigated the topological alterations involving brain structural covariance networks in MHE patients for the first time. Our results suggest that MHE patients exhibit an unoptimizable architecture involving the gray matter structural covariance network and provide structural evidence supporting that MHE is a neurological complication related to disrupted neural networks.
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