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Correlation between Electroencephalogram, Hepatic Encephalopathy Grade, and Biochemical Indices in Beagles with Portacaval Anastomosis
Author(s) -
Okamoto Hiroh,
Fujimura Takao,
Yashiro Kazuhiro
Publication year - 1985
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607185009003326
Subject(s) - hepatic encephalopathy , medicine , portacaval anastomosis , chemistry , encephalopathy , cirrhosis , endocrinology , gastroenterology , alkaline phosphatase , ammonia , aromatic amino acids , biochemistry , amino acid , enzyme , portal hypertension
The EEG, grades of hepatic encephalopathy, and biochemical indices of 16 beagles with portacaval anastomosis were recorded throughout their lives and correlations between these parameters were investigated. The degree of deterioration of some biochemical indices, such as the ammonia concentration, glutamate oxaloacetate transaminase and alkaline phosphatase activities in the plasma, and percentage loss of body weight showed a progressive increase parallel to the severity of the hepatic encephalopathy (HE) grade (grading scale 0‐IV), but other biochemical indices such as the concentrations of aromatic or branched‐chain amino acids, the molar ratio of branched‐chain to aromatic amino acids, or the total protein concentration in the plasma did not show such relationship. The SW ratio, an index of the incidence of slow‐waves in the EEG, was calculated from frequency distribution histograms which were obtained by frequency analyses of EEG recordings. A slight but significant correlation was found between the SW ratio and the plasma ammonia concentration. In addition, the SW ratio consistently increased with increase in the HE grade, although the SW ratio in HE grade IV was below the normal range for beagles. These results show that only the ammonia concentration in the plasma correlates with deterioration of the HE grade and of the SW ratio, suggesting that changes in ammonia concentration in the plasma should be of diagnostic value in assessing changes in mental state and the EEG in patients with liver cirrhosis. The importance of ammonia in pathogenesis of HE is stressed. (Journal of Parenteral and Enteral Nutrition 9:326–333, 1985)