{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:41:51Z","timestamp":1785775311599,"version":"3.56.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":973,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>Studies have shown decreased cerebral oxygen metabolism (CMRO<jats:sub>2<\/jats:sub>) and blood flow (CBF) in patients with cirrhosis with hepatic encephalopathy (HE). It remains unclear, however, whether these disturbances are associated with HE or with cirrhosis itself and how they may relate to arterial blood ammonia concentration and cerebral metabolic rate of blood ammonia (CMRA). We addressed these questions in a paired study design by investigating patients with cirrhosis during and after recovery from an acute episode of HE type C. CMRO<jats:sub>2<\/jats:sub>, CBF, and CMRA were measured by dynamic positron emission tomography (PET)\/computed tomography (CT). Ten patients with cirrhosis were studied during an acute episode of HE; nine were reexamined after recovery. Nine patients with cirrhosis with no history of HE served as controls. Mean CMRO<jats:sub>2<\/jats:sub> increased from 0.73 \u03bcmol oxygen\/mL brain tissue\/min during HE to 0.91 \u03bcmol oxygen\/mL brain tissue\/min after recovery (paired <jats:italic toggle=\"yes\">t<\/jats:italic> test; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). Mean CBF increased from 0.28 mL blood\/mL brain tissue\/min during HE to 0.38 mL blood\/mL brain tissue\/min after recovery (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). After recovery from HE, CMRO<jats:sub>2<\/jats:sub> and CBF were not significantly different from values in the control patients. Arterial blood ammonia concentration decreased 20% after recovery (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05) and CMRA was unchanged (<jats:italic toggle=\"yes\">P<\/jats:italic> &gt; 0.30); both values were higher than in the control patients (both <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: The low values of CMRO<jats:sub>2<\/jats:sub> and CBF observed during HE increased after recovery from HE and were thus associated with HE rather than the liver disease as such. The changes in CMRO<jats:sub>2<\/jats:sub> and CBF could not be linked to blood ammonia concentration or CMRA. (Hepatology 2013)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.25995","type":"journal-article","created":{"date-parts":[[2012,8,10]],"date-time":"2012-08-10T11:07:02Z","timestamp":1344596822000},"page":"258-265","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":63,"title":["Hepatic encephalopathy is associated with decreased cerebral oxygen metabolism and blood flow, not increased ammonia uptake"],"prefix":"10.1097","volume":"57","author":[{"given":"Gitte","family":"Dam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Keiding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole L.","family":"Munk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Vilstrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse K.","family":"Bak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle S.","family":"Waagepetersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Schousboe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"S\u03c6rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-28-20241201","doi-asserted-by":"crossref","first-page":"697706","DOI":"10.1016\/j.neuint.2011.09.007","article-title":"Brain energy metabolism and mitochondrial dysfunction in acute and chronic hepatic encephalopathy.","volume":"60","author":"Rama Rao","year":"2012","journal-title":"Neurochem Int"},{"key":"R2-28-20241201","doi-asserted-by":"crossref","first-page":"369376","DOI":"10.1002\/hep.510270209","article-title":"Cerebral blood flow and metabolism in patients with chronic liver disease undergoing orthotopic liver transplantation.","volume":"27","author":"Philips","year":"1998","journal-title":"HEPATOLOGY"},{"key":"R3-28-20241201","doi-asserted-by":"crossref","first-page":"663670","DOI":"10.1016\/0016-5085(80)90665-4","article-title":"Successful use of bromocriptine in the treatment of chronic hepatic encephalopathy.","volume":"78","author":"Morgan","year":"1980","journal-title":"Gastroenterology"},{"key":"R4-28-20241201","doi-asserted-by":"crossref","first-page":"299303","DOI":"10.3109\/00365528909093050","article-title":"Cerebral blood flow and liver function in patients with encephalopathy due to acute and chronic liver diseases.","volume":"24","author":"Almdal","year":"1989","journal-title":"Scand J Gastroenterol"},{"key":"R5-28-20241201","doi-asserted-by":"crossref","first-page":"863871","DOI":"10.1053\/j.gastro.2008.10.057","article-title":"Low cerebral oxygen consumption and blood flow in patients with cirrhosis and an acute episode of hepatic encephalopathy.","volume":"136","author":"Iversen","year":"2009","journal-title":"Gastroenterology"},{"key":"R6-28-20241201","first-page":"306314","article-title":"Alteration of regional cerebral metabolism in patients with cirrhosis in positron emission tomography.","volume":"92","author":"Ikeda","year":"2001","journal-title":"Fukuoka Igaku Zasshi"},{"key":"R7-28-20241201","doi-asserted-by":"crossref","first-page":"103117","DOI":"10.1007\/s11011-008-9113-6","article-title":"Signaling factors in the mechanism of ammonia neurotoxicity.","volume":"24","author":"Norenberg","year":"2009","journal-title":"Metab Brain Dis"},{"key":"R8-28-20241201","doi-asserted-by":"crossref","first-page":"420428","DOI":"10.1053\/jhep.2003.50052","article-title":"Selective increase of brain lactate synthesis in experimental acute liver failure: results of a HC nuclear magnetic resonance study.","volume":"37","author":"Zwingmann","year":"2003","journal-title":"HEPATOLOGY"},{"key":"R9-28-20241201","doi-asserted-by":"crossref","first-page":"691705","DOI":"10.1002\/glia.20955","article-title":"Ammonia triggers exocytotic release of Lglutamate from cultured rat astrocytes.","volume":"58","author":"Gorg","year":"2010","journal-title":"Glia"},{"key":"R10-28-20241201","doi-asserted-by":"crossref","first-page":"449460","DOI":"10.1172\/JCI109322","article-title":"The dynamics of ammonia metabolism in man. Effects of liver disease and hyperammonemia.","volume":"63","author":"Lockwood","year":"1979","journal-title":"J Clin Invest"},{"key":"R11-28-20241201","first-page":"1056","article-title":"Brain metabolism of 13Nammonia during acute hepatic encephalopathy in cirrhosis measured by positron emission tomography. HEPATOLOGY, 2006; 43: 4250.","volume":"44","author":"Keiding","year":"2006","journal-title":"Erratum, Hepatology"},{"key":"R12-28-20241201","doi-asserted-by":"crossref","first-page":"716721","DOI":"10.1053\/jhep.2002.31250","article-title":"Hepatic encephalopathydefinition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998.","volume":"35","author":"Ferenci","year":"2002","journal-title":"HEPATOLOGY"},{"key":"R13-28-20241201","first-page":"1119","article-title":"Reaction time and brain disease: relations to location, etiology and progression of cerebral dysfunction.","volume":"71","author":"Elsass","year":"1985","journal-title":"Acta Neurol Scand"},{"key":"R14-28-20241201","doi-asserted-by":"crossref","first-page":"151157","DOI":"10.1016\/0009-8981(74)90223-X","article-title":"A kinetic determination of ammonia in plasma.","volume":"56","author":"van Anken","year":"1974","journal-title":"Clin Chim Acta"},{"key":"R15-28-20241201","doi-asserted-by":"crossref","first-page":"108111","DOI":"10.1164\/arrd.1965.91.1.108","article-title":"Further observations on the lack of effect of isoniazid on the blood ammonia concentration.","volume":"91","author":"Conn","year":"1965","journal-title":"Am Rev Respir Dis"},{"key":"R16-28-20241201","doi-asserted-by":"crossref","first-page":"34713481","DOI":"10.1118\/1.2948391","article-title":"A method to estimate dispersion in sampling catheters and to calculate dispersionfree blood timeactivity curves.","volume":"35","author":"Munk","year":"2008","journal-title":"Med Phys"},{"key":"R17-28-20241201","doi-asserted-by":"crossref","first-page":"4956","DOI":"10.1007\/s11011-010-9181-2","article-title":"Human 13Nammonia PET studies: the importance of measuring 13Nammonia metabolites in blood.","volume":"25","author":"Keiding","year":"2010","journal-title":"Metab Brain Dis"},{"key":"R19-28-20241201","doi-asserted-by":"crossref","first-page":"358364","DOI":"10.1161\/01.RES.35.3.358","article-title":"Evidence of the limitations of water as a freely diffusible tracer in brain of the rhesus monkey.","volume":"35","author":"Eichling","year":"1974","journal-title":"Circ Res"},{"key":"R20-28-20241201","doi-asserted-by":"crossref","first-page":"5763","DOI":"10.1007\/s11011-010-9179-9","article-title":"No oxygen delivery limitation in hepatic encephalopathy.","volume":"25","author":"Gjedde","year":"2010","journal-title":"Metab Brain Dis"},{"key":"R22-28-20241201","doi-asserted-by":"crossref","first-page":"182187","DOI":"10.1159\/000116153","article-title":"Cerebrospinal fluid lactate in patients with hepatic encephalopathy.","volume":"27","author":"Yao","year":"1987","journal-title":"Eur Neurol"},{"key":"R23-28-20241201","doi-asserted-by":"crossref","first-page":"389394","DOI":"10.1016\/j.neuint.2010.06.012","article-title":"Increase brain lactate in hepatic encephalopathy: cause or consequence?","volume":"57","author":"Rose","year":"2010","journal-title":"Neurochem Int"},{"key":"R24-28-20241201","doi-asserted-by":"crossref","first-page":"13761386","DOI":"10.1111\/j.1471-4159.1986.tb00768.x","article-title":"Brain alphaketoglutarate dehydrogenase complex: kinetic properties, regional distribution, and effects of inhibitors.","volume":"47","author":"Lai","year":"1986","journal-title":"J Neurochem"},{"key":"R25-28-20241201","doi-asserted-by":"crossref","first-page":"135145","DOI":"10.1007\/s11011-008-9123-4","article-title":"Metabolic fate of isoleucine in a rat model of hepatic encephalopathy and in cultured neural cells exposed to ammonia.","volume":"24","author":"Bak","year":"2009","journal-title":"Metab Brain Dis"},{"key":"R26-28-20241201","doi-asserted-by":"crossref","first-page":"10421051","DOI":"10.1016\/j.neuint.2007.01.009","article-title":"The metabolic role of isoleucine in detoxification of ammonia in cultured mouse neurons and astrocytes.","volume":"50","author":"Johansen","year":"2007","journal-title":"Neurochem Int"},{"key":"R27-28-20241201","doi-asserted-by":"crossref","first-page":"17361742","DOI":"10.1136\/gut.2006.110569","article-title":"Correlations between magnetic resonance spectroscopy alterations and cerebral ammonia and glucose metabolism in cirrhotic patients with and without hepatic encephalopathy.","volume":"56","author":"Weissenborn","year":"2007","journal-title":"Gut"},{"key":"R28-28-20241201","doi-asserted-by":"crossref","first-page":"8183","DOI":"10.1126\/science.183.4120.81","article-title":"Alphaketoglutaramate: increased concentrations in the cerebrospinal fluid of patients in hepatic coma.","volume":"183","author":"Vergara","year":"1974","journal-title":"Science"},{"key":"R29-28-20241201","doi-asserted-by":"crossref","first-page":"7380","DOI":"10.1007\/s11011-010-9172-3","article-title":"Hyponatremic and hepatic encephalopathies: similarities, differences and coexistence.","volume":"25","author":"Cordoba","year":"2010","journal-title":"Metab Brain Dis"},{"key":"R30-28-20241201","doi-asserted-by":"crossref","first-page":"11371142","DOI":"10.1111\/j.1478-3231.2010.02293.x","article-title":"Risk factors for hepatic encephalopathy in patients with cirrhosis and refractory ascites: relevance of serum sodium concentration.","volume":"30","author":"Guevara","year":"2010","journal-title":"Liver Int"},{"key":"R31-28-20241201","doi-asserted-by":"crossref","first-page":"13821389","DOI":"10.1038\/ajg.2009.293","article-title":"Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with timedependent analysis.","volume":"104","author":"Guevara","year":"2009","journal-title":"Am J Gastroenterol"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.25995","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-201301000-00028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T14:02:43Z","timestamp":1733061763000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-201301000-00028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.25995","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}