IRISH SOCIETY OF GASTROENTEROLOGY 2021

Hepatology Poster Awards 2021 - First Prize

Dr Damien Ferguson
St James’s Hospital Dublin

TBA (21W142)

Cortical thinning and cerebral atrophy in non-cirrhotic, hepatitis C virus associated neurocognitive dysfunction.

Author(s)

Ferguson D, Strahan O, Bergin C, McKiernan S, Doherty C and Norris S

Department(s)/Institutions

Academic Unit of Neurology, School of Medicine, University of Dublin, Trinity College, Dublin 2. Neurology Department, St. James’s Hospital, Dublin 8. School of Psychology, University of Dublin, Trinity College, Dublin 2. Infectious Diseases Department, St. James’s Hospital, Dublin 8. School of Medicine, University of Dublin, Trinity College, Dublin 2. Hepatology Department, St. James’s Hospital, Dublin 8.

Introduction

Hepatitis C virus associated neurocognitive dysfunction (HCV-AND) occurs independent of liver cirrhosis. The underlying mechanism is poorly understood but functional neuroimaging suggests neuroinflammation and altered neurotransmission. Cerebral atrophy is associated with cognitive impairment in disorders such as HIV-associated dementia, multiple sclerosis and Alzheimer’s disease but has not been examined in HVC-AND.

Aims/Background

To investigate for changes in brain morphometry in HCV-AND.

Method

Non-cirrhotic, HCVRNA positive patients with HCV-AND underwent high resolution 3-dimensional (3D) volumetric T1-weighted brain imaging on a 3 Tesla (3T) Philips Achieva system. Whole brain and segmented morphometric data were extracted using FreeSurfer software pipelines. Imaging was compared to age- and gender-matched healthy controls.

Results

Seventy-four patients (38% female, mean age 40 years, median liver stiffness 5.8 kPa) underwent volumetric brain MRI. Mean left and right hemisphere cortex was significantly thinner in the HCV-AND group compared to the control group (left: 2.46 ± 0.08 mm vs. 2.52 ± 0.06 mm, t -3.877, p = 0.000252; right: 2.45 ± 0.09 mm vs. 2.52 ± 0.06 mm, t -4.378, p = 0.000038). White matter volume was lower in the HCV-AND group compared to the control group (498,427.7 ± 70,905.8 mm3 vs. 467,181.9 ± 56,153.5 mm3, t 2.328, p = 0.022). Total subcortical grey matter volume was lower in the HCV-AND group in comparison to the control group (57,788.5 ± 5,581 mm3 vs. 60,446.4 ± 6,175.9 mm3, t 2.084, p = 0.04).

Conclusions

Cortical thinning and grey and white matter volume loss occur in non-cirrhotic HCVRNA positive patients with HCV-AND and may result from chronic HCV induced neuroinflammation.