Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8687645 | NeuroImage: Clinical | 2018 | 29 Pages |
Abstract
Branched-chain amino acids increase the brain perfusion of patients with hepatic encephalopathy (HE), but the amino acid and the mechanisms involved are still unknown. This study compared brain perfusion and clinical improvement during leucine or isoleucine supplementation. After randomization, 27 subjects with cirrhosis and HE received leucine or isoleucine supplements for one year. Brain single Photon Emission Computed Tomography (SPECT) and dynamic brain scintigraphy (DBS) were performed pretreatment and at 1, 8 and 12â¯months of supplementation. Brain perfusion was increased only in the isoleucine group at 8â¯months of treatment by both SPECT and DBS (pâ¯<â¯0.001 and pâ¯=â¯0.05, respectively) and by SPECT at the 12th month (pâ¯<â¯0.05). This was associated with hepatic encephalopathy improvement at 8 and 12â¯months (pâ¯=â¯0.008 and 0.004, respectively), which was not observed in the leucine group (pâ¯=â¯0.313 and 0.055, respectively). Isoleucine supplementation achieved a better impact on brain perfusion restoration in HE.
Keywords
APMTGLNHRQOLSF-36CBFTSFHGSMAMCGDHPDHTCAα-KGFDRNH3BCKAROIsROSα-ketoglutarateAmmoniabranched-chain amino acidshepatic encephalopathytricarboxylic acidElectroencephalogramSPECTBCAAsingle photon emission computed tomographycerebral blood flowarm circumferenceliver cirrhosisbody mass indexBMIHandgrip strengthα-ketoglutarate dehydrogenase complexmid-arm muscle circumferenceModel of End-stage Liver DiseaseRegions Of Interestfalse discovery rateEEGtriceps skinfoldpyruvate dehydrogenase complexhigh-performance liquid chromatographyHPLCHealth-related quality of lifeMELDGluglutamateglutamate dehydrogenaseglutamineReactive oxygen species
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Authors
Fernando Gomes Romeiro, Marjorie do Val Ietsugu, LetÃcia de Campos Franzoni, LaÃs Augusti, Matheus Alvarez, LÃvia Alves Amaral Santos, Talles Bazeia Lima, Kátia Hiromoto Koga, Sônia Marta Moriguchi, Carlos Antonio Caramori, Giovanni Faria Silva,