Analysis Of Brain Network Topological Properties Of Acute-on-chronic Liver Failure With Hepatic Encephalopathy

Objective: To observe the difference in topological properties of resting brain network between patients with acute-on-chronic liver failure and those with or without hepatic encephalopathy.Methods: Twenty-eight patients with acute-on-chronic liver failure were enrolled in the clinical diagnosis.Among them,patients were divided into 12 ACLF with HE(ACLF-HE)and 16 ACLF without HE(ACLF-NHE),and17 age-matched healthy persons in the HC group.All subjects underwent resting state functional magnetic resonance imaging(fMRI),using the graph theory method to analyze the global and node topology properties of the brain network.The obtained parameters were analyzed by one-way ANOVA and post-test analysis..Results: From HC group to ACLF-NHE group to ACLF-HE group,the clustering coefficient,global efficiency and local efficiency of the three groups gradually decreased,and the shortest path length showed a trend of increasing gradually,but the difference was not statistically significant(P>0.05).The cluster coefficient,global efficiency and local efficiency ofACLF-HE group occipital lobe(calcarine fissure,lingual gyrus),subcortical structure(caudate nucleus,putamen,pallidus,thalamus)were significantly lower than those of ACLF-NHE group(P<0.05),the shortest path length of temporal lobe(heschl gyrus,inferior temporal gyrus)was significantly higher than that of ACLF-NHE group(P<0.05).Compared with HC group,ACLF with or without HE showed default mode network and subcortical structure of the brain network topology attributes are reduced.The ACLF-HE group also have an increase in the global efficiency of right hippocampus and right inferior temporal gyrus.Conclusion: The alteration of the topological properties of the occipital lobe,subcortical structure and temporal lobe may participate in the brain network mechanism of ACLF-HE.