Specific Gut and Salivary Microbiota Patterns Are Linked With Different Cognitive Testing Strategies in Minimal Hepatic Encephalopathy

The American Journal of Gastroenterology
Jasmohan S BajajPatrick M Gillevet

Abstract

Minimal hepatic encephalopathy (MHE) is epidemic in cirrhosis, but testing strategies often have poor concordance. Altered gut/salivary microbiota occur in cirrhosis and could be related to MHE. Our aim was to determine microbial signatures of individual cognitive tests and define the role of microbiota in the diagnosis of MHE. Outpatients with cirrhosis underwent stool collection and MHE testing with psychometric hepatic encephalopathy score (PHES), inhibitory control test, and EncephalApp Stroop. A subset provided saliva samples. Minimal hepatic encephalopathy diagnosis/concordance between tests was compared. Stool/salivary microbiota were analyzed using 16srRNA sequencing. Microbial profiles were compared between patients with/without MHE on individual tests. Logistic regression was used to evaluate clinical and microbial predictors of MHE diagnosis. Two hundred forty-seven patients with cirrhosis (123 prior overt HE, MELD 13) underwent stool collection and PHES testing; 175 underwent inhibitory control test and 125 underwent Stroop testing. One hundred twelve patients also provided saliva samples. Depending on the modality, 59%-82% of patients had MHE. Intertest Kappa for MHE was 0.15-0.35. Stool and salivary microbiota pro...Continue Reading

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Citations

Sep 11, 2019·Journal of Pediatric Gastroenterology and Nutrition·Daniella OhnemusEstella M Alonso
Mar 18, 2020·Liver International : Official Journal of the International Association for the Study of the Liver·Jasmohan S BajajPatrick M Gillevet
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Jul 12, 2019·World Journal of Hepatology·Daniela CampionCarlo Alessandria
Dec 3, 2020·Journal of Clinical Medicine·Yoann MaitreFrederic Denis
Feb 1, 2020·Journal of Hepatology·Jasmohan S Bajaj, Alexander Khoruts
Jan 26, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Somaya AlbhaisiJasmohan S Bajaj
Mar 5, 2021·The American Journal of Gastroenterology·Jasmohan S Bajaj
Jul 18, 2020·Journal of Hepatology·Krishnakant SabooJasmohan S Bajaj

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