{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T11:07:12Z","timestamp":1771931232344,"version":"3.50.1"},"reference-count":82,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":6148,"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":[[1998,11]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>A prospective study of hepatic encephalopathy (HE) including neuropsychiatric and psychometric evaluation, electroencephalography, and determination of arterial ammonia levels was performed in 55 cirrhotic patients treated consecutively by transjugular intrahepatic portosystemic shunt (TIPS). The cumulative HE rate increased from 23.6% within the 3\u2013month interval before TIPS to 50.9% within the first 3\u2013month interval post\u2013TIPS (<jats:italic toggle=\"yes\">P<\/jats:italic> = .003). Significant and independent predictors of HE post\u2013TIPS were the presence of HE pre\u2013TIPS and reduced liver function. The cumulative HE rate declined in the second 3\u2013month interval post\u2013TIPS and reached the pre\u2013TIPS level. Chronic forms of HE exceeding grade I were not observed. In a subgroup of 22 nonencephalopathic TIPS patients, the prevalence of subclinical HE did not change after TIPS. Among individual psychometric tests, the block design test gave the highest proportion of pathological results (about 50%), whereas selective reminding gave the lowest (10%\u201325%). Electroencephalography (EEG) showed a temporary increase of pathological results at 1 month after TIPS, when patients with overt HE (grade I) were included (proportion of 21.1% before vs. 57.1%, <jats:italic toggle=\"yes\">P<\/jats:italic> = .005). Arterial ammonia concentration increased from a mean of 94 \u00b1 26 \u03bcg\/dL to 140 \u00b1 28 \u03bcg\/dL at 3 months after TIPS (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .001). Elevated ammonia levels persisted. TIPS led to a temporary increase of HE incidence within 3 months. The decline of the HE rate beyond 3 months despite a sustained increase of arterial ammonia levels could not entirely be explained by reduction of shunt flow, nor by alteration of liver function. Instead, cerebral adaptation to gut\u2013derived neurotoxins might be anticipated.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510280508","type":"journal-article","created":{"date-parts":[[2004,7,27]],"date-time":"2004-07-27T23:30:02Z","timestamp":1090971002000},"page":"1215-1225","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":138,"title":["Portosystemic Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt in Patients With Cirrhosis: Clinical, Laboratory, Psychometric, and Electroencephalographic Investigations"],"prefix":"10.1097","volume":"28","author":[{"given":"Wilhelm","family":"Nolte","sequence":"first","affiliation":[]},{"given":"Jens","family":"Wiltfang","sequence":"additional","affiliation":[]},{"given":"Christian","family":"Schindler","sequence":"additional","affiliation":[]},{"given":"Hans","family":"M\u00fcnke","sequence":"additional","affiliation":[]},{"given":"Knut","family":"Unterberg","sequence":"additional","affiliation":[]},{"given":"Uta","family":"Zumhasch","sequence":"additional","affiliation":[]},{"given":"Hans R.","family":"Figulla","sequence":"additional","affiliation":[]},{"given":"Gerald","family":"Werner","sequence":"additional","affiliation":[]},{"given":"Heinz","family":"Hartmann","sequence":"additional","affiliation":[]},{"given":"Giuliano","family":"Ramadori","sequence":"additional","affiliation":[]}],"member":"276","reference":[{"key":"10.1002\/hep.510280508-BIB1|cit1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0140-6736(54)91874-7","article-title":"Portal-systemic encephalopathy. Neurological complications of liver disease","volume":"ii","author":"Sherlock","year":"1954","journal-title":"Lancet"},{"key":"10.1002\/hep.510280508-BIB2|cit2","volume-title":"Hepatic Encephalopathy: Syndromes and Therapies.","author":"Conn","year":"1994"},{"key":"10.1002\/hep.510280508-BIB3|cit3","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3181\/00379727-206-43770","article-title":"Current theories on the pathogenesis of hepatic encephalopathy","volume":"206","author":"Mousseau","year":"1994","journal-title":"Proc Soc Exp Biol Med"},{"key":"10.1002\/hep.510280508-BIB4|cit4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1055\/s-2007-1023994","article-title":"Diagnostik der hepatischen Enzephalopathien","volume":"121","author":"Nolte","year":"1996","journal-title":"Dtsch Med Wochenschr"},{"key":"10.1002\/hep.510280508-BIB5|cit5","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0016-5085(74)80177-0","article-title":"Portal-systemic encephalopathy and portacaval anastomosis: a prospective controlled investigation","volume":"66","author":"Mutchnick","year":"1974","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510280508-BIB6|cit6","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/00000658-198304000-00008","article-title":"Portacaval H-graft: relationships of shunt diameter, portal flow patterns and encephalopathy","volume":"197","author":"Sarfeh","year":"1983","journal-title":"Ann Surg"},{"key":"10.1002\/hep.510280508-BIB7|cit7","first-page":"126","article-title":"Portal hemodynamics, intestinal absorption, and postshunt encephalopathy","volume":"94","author":"Rikkers","year":"1983","journal-title":"Surgery"},{"key":"10.1002\/hep.510280508-BIB8|cit8","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1002\/hep.1840080602","article-title":"Distal splenorenal vs. portal-systemic shunts after hemorrhage from varices: a randomized controlled trial","volume":"8","author":"Grace","year":"1988","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB9|cit9","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1001\/archsurg.1988.01400320073015","article-title":"Should portosystemic shunt be reconsidered in the treatment of intractable ascites in cirrhosis?","volume":"123","author":"Franco","year":"1988","journal-title":"Arch Surg"},{"key":"10.1002\/hep.510280508-BIB10|cit10","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/hep.1840150411","article-title":"Long-term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: importance of reversal of portal blood flow","volume":"15","author":"Lacy","year":"1992","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB11|cit11","first-page":"1792","article-title":"Prognostic factors of hepatic encephalopathy after portacaval anastomosis: a multivariate analysis in 50 patients","volume":"87","author":"Planas","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB12|cit12","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/00000658-199404000-00005","article-title":"Partial versus total portacaval shunt in alcoholic cirrhosis","volume":"219","author":"Sarfeh","year":"1994","journal-title":"Ann Surg"},{"key":"10.1002\/hep.510280508-BIB13|cit13","first-page":"95","article-title":"Portale Hypertension interdisziplin\u00e4r: Stellenwert der portosystemischen Shuntoperation","volume":"120","author":"H\u00e4ring","year":"1995","journal-title":"Zentralbl Chir"},{"key":"10.1002\/hep.510280508-BIB14|cit14","first-page":"566","article-title":"Sind chirurgische Shunts noch indiziert?","volume":"66","author":"Otto","year":"1995","journal-title":"Chirurg"},{"key":"10.1002\/hep.510280508-BIB15|cit15","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1002\/bjs.1800820219","article-title":"Mesocaval interposition shunt with small-diameter polytetrafluoroethylene grafts in sclerotherapy failure","volume":"82","author":"Paquet","year":"1995","journal-title":"Br J Surg"},{"key":"10.1002\/hep.510280508-BIB16|cit16","first-page":"406","article-title":"Der transjugul\u00e4re intrahepatische portosystemische Stent-Shunt (TIPSS)","volume":"29","author":"Richter","year":"1989","journal-title":"Radiologe"},{"key":"10.1002\/hep.510280508-BIB17|cit17","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/hep.1840220536","article-title":"The role of transjugular intrahepatic portosystemic shunt for treatment of portal hypertension and its complications: a conference sponsored by the national digestive diseases advisory board","volume":"22","author":"Shiffman","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB18|cit18","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S0168-8278(96)80079-1","article-title":"The transjugular intrahepatic portosystemic shunt","volume":"25","author":"R\u00f6ssle","year":"1996","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB19|cit19","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/S0016-5085(96)70035-5","article-title":"Transvenous intrahepatic portosystemic shunts","volume":"111","author":"Kamath","year":"1996","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510280508-BIB20|cit20","first-page":"719","article-title":"Transjugular intrahepatic portosystemic shunt in the management of variceal bleeding: indications and clinical results","volume":"114","author":"Martin","year":"1993","journal-title":"Surgery"},{"key":"10.1002\/hep.510280508-BIB21|cit21","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1148\/radiology.189.3.8234706","article-title":"Refractory ascites: early experience in treatment with transjugular intrahepatic portosystemic shunt","volume":"189","author":"Ferral","year":"1993","journal-title":"Radiology"},{"key":"10.1002\/hep.510280508-BIB22|cit22","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/S0002-9610(05)80128-X","article-title":"The role of transjugular intrahepatic portosystemic shunts in the management of patients with end-stage liver disease","volume":"168","author":"Forster","year":"1994","journal-title":"Am J Surg"},{"key":"10.1002\/hep.510280508-BIB23|cit23","first-page":"565","article-title":"Transjugular intrahepatic portosystemic stent-shunt (TIPSS): long-term follow-up","volume":"87","author":"Jalan","year":"1994","journal-title":"Quart J Med"},{"key":"10.1002\/hep.510280508-BIB24|cit24","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1056\/NEJM199401203300303","article-title":"The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding","volume":"330","author":"R\u00f6ssle","year":"1994","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.510280508-BIB25|cit25","first-page":"46","article-title":"Portosystemic encephalopathy after transjugular intrahepatic portosystemic shunt: results of a prospective controlled study","volume":"20","author":"Sanyal","year":"1994","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB26|cit26","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1148\/radiology.196.2.7617842","article-title":"Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension","volume":"196","author":"Coldwell","year":"1995","journal-title":"Radiology"},{"key":"10.1002\/hep.510280508-BIB27|cit27","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1056\/NEJM199505043321803","article-title":"The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites","volume":"332","author":"Ochs","year":"1995","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.510280508-BIB28|cit28","first-page":"986","article-title":"Transjugular intrahepatic portal-systemic shunt in the treatment of refractory ascites: effect on clinical, renal, humoral, and hemodynamic parameters","volume":"21","author":"Quiroga","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB29|cit29","doi-asserted-by":"crossref","first-page":"816","DOI":"10.7326\/0003-4819-122-11-199506010-00002","article-title":"Transjugular intrahepatic portosystemic stent shunt: effects on hemodynamics and sodium homeostasis in cirrhosis and refractory ascites","volume":"122","author":"Wong","year":"1995","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510280508-BIB30|cit30","first-page":"549","article-title":"Hepatic encephalopathy after transjugular intrahepatic portosystemic shunts: incidence and risk factors","volume":"90","author":"Somberg","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB31|cit31","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/0168-8278(95)80036-0","article-title":"A prospective evaluation of changes in neuropsychological and liver function tests following transjugular intrahepatic portosystemic stent-shunt","volume":"23","author":"Jalan","year":"1995","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB32|cit32","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/0168-8278(95)80325-4","article-title":"Analysis of prognostic variables in the prediction of mortality, shunt failure, variceal rebleeding and encephalopathy following the transjugular intrahepatic portosystmic stent-shunt for variceal haemorrhage","volume":"23","author":"Jalan","year":"1995","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB33|cit33","first-page":"555","article-title":"Portale hypertension und percutan transjugul\u00e4r angelegte portosystemische stent-shunts (TIPSS)","volume":"66","author":"Richter","year":"1995","journal-title":"Chirurg"},{"key":"10.1002\/hep.510280508-BIB34|cit34","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1016\/0016-5085(95)90213-9","article-title":"Two-year outcome following transjugular intrahepatic portosystemic shunt for variceal bleeding: results in 90 patients","volume":"108","author":"LaBerge","year":"1995","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510280508-BIB35|cit35","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0168-8278(96)80065-1","article-title":"Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial","volume":"25","author":"Lebrec","year":"1996","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB36|cit36","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1002\/lt.500020210","article-title":"Transjugular intrahepatic portosystemic shunt in patients with end-stage liver disease: results in 85 patients","volume":"2","author":"Jabbour","year":"1996","journal-title":"Liver Transplant Surg"},{"key":"10.1002\/hep.510280508-BIB37|cit37","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1053\/gast.1996.v110.pm8608893","article-title":"Transjugular intrahepatic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage","volume":"110","author":"Cabrera","year":"1996","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510280508-BIB38|cit38","doi-asserted-by":"crossref","first-page":"858","DOI":"10.7326\/0003-4819-126-11-199706010-00002","article-title":"Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage","volume":"126","author":"Cello","year":"1997","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510280508-BIB39|cit39","doi-asserted-by":"crossref","first-page":"849","DOI":"10.7326\/0003-4819-126-11-199706010-00001","article-title":"Transjugular intrahepatic portosystemic shunts compared with endoscopic sclerotherapy for the prevention of recurrent variceal hemorrhage","volume":"126","author":"Sanyal","year":"1997","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510280508-BIB40|cit40","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/S0140-6736(96)08189-5","article-title":"Randomised trial of transjugular-intrahepatic-portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding","volume":"349","author":"R\u00f6ssle","year":"1997","journal-title":"Lancet"},{"key":"10.1002\/hep.510280508-BIB41|cit41","first-page":"264","article-title":"Erste klinische Erfahrungen mit TIPS (transjugul\u00e4rer intrahepatischer portosystemischer stent-shunt)","volume":"25","author":"Nolte","year":"1995","journal-title":"Leber Magen Darm"},{"key":"10.1002\/hep.510280508-BIB42|cit42","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh","year":"1973","journal-title":"Br J Surg"},{"key":"10.1002\/hep.510280508-BIB43|cit43","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/BF01072510","article-title":"Trailmaking and number-connection tests in the assessment of mental state in portal systemic encephalopathy","volume":"22","author":"Conn","year":"1977","journal-title":"Dig Dis"},{"key":"10.1002\/hep.510280508-BIB44|cit44","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/1097-4679(196801)24:1<96::AID-JCLP2270240131>3.0.CO;2-U","article-title":"The influence of age on trail making test performance","volume":"24","author":"Davies","year":"1968","journal-title":"J Clin Psychol"},{"key":"10.1002\/hep.510280508-BIB45|cit45","volume-title":"Neuropsychological Assessment.","author":"Lezak","year":"1995"},{"key":"10.1002\/hep.510280508-BIB46|cit46","volume-title":"HAWIE f\u00fcr Erwachsene, Revision 1991.","author":"Tewes","year":"1991"},{"key":"10.1002\/hep.510280508-BIB47|cit47","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/S0022-5371(73)80034-9","article-title":"Selective reminding for analysis of memory and learning","volume":"12","author":"Buschke","year":"1973","journal-title":"J Verb Learn Verb Behav"},{"key":"10.1002\/hep.510280508-BIB48|cit48","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S0140-6736(57)90005-3","article-title":"The electroencephalograph in liver disease","volume":"ii","author":"Parsons-Smith","year":"1957","journal-title":"Lancet"},{"key":"10.1002\/hep.510280508-BIB49|cit49","first-page":"426","article-title":"Direkte Plasmaammoniakbestimmung ohne Enteiwei\u00dfung","volume":"11","author":"Da Fonseca-Wollheim","year":"1973","journal-title":"Z Klin Chem Klin Biochem"},{"key":"10.1002\/hep.510280508-BIB50|cit50","first-page":"421","article-title":"Bedeutung von Wasserstoffionenkonzentration und ADP-Zusatz bei der Ammoniakbestimmung mit Glutamatdehydrogenase","volume":"11","author":"Da Fonseca-Wollheim","year":"1973","journal-title":"Z Klin Chem Klin Biochem"},{"key":"10.1002\/hep.510280508-BIB51|cit51","doi-asserted-by":"crossref","first-page":"151","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":"10.1002\/hep.510280508-BIB52|cit52","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1002\/hep.510250609","article-title":"Therapeutic efficacy of L-Ornithine-L-Aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study","volume":"25","author":"Kirchheis","year":"1997","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB53|cit53","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0378-3758(96)00177-2","article-title":"A unified approach to rank tests for mixed models","volume":"61","author":"Akritas","year":"1997","journal-title":"J Stat Plann and Infer"},{"key":"10.1002\/hep.510280508-BIB54|cit54","doi-asserted-by":"crossref","unstructured":"Kaplan EL Meier P J Am Statist Assoc 1958 457 481","DOI":"10.1080\/01621459.1958.10501452"},{"key":"10.1002\/hep.510280508-BIB55|cit55","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/00000658-199609000-00014","article-title":"A prospective trial of transjugular intrahepatic portasystemic stent shunts versus small-diameter prosthetic H-graft portacaval shunts in the treatment of bleeding varices","volume":"224","author":"Rosemurgy","year":"1996","journal-title":"Ann Surg"},{"key":"10.1002\/hep.510280508-BIB56|cit56","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1002\/hep.510250636","article-title":"Ammonia and GABA-ergic neurotransmission: interrelated factors in the pathogenesis of hepatic encephalopathy","volume":"25","author":"Basile","year":"1997","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB57|cit57","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1080\/00365521.1970.12096655","article-title":"Encephalopathy and portacaval anastomosis","volume":"5","author":"Kardel","year":"1970","journal-title":"Scand J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB58|cit58","doi-asserted-by":"crossref","first-page":"305","DOI":"10.3109\/00365527709180932","article-title":"Chronic hepatic encephalopathy. A psychometrical study","volume":"12","author":"Rehnstr\u00f6m","year":"1977","journal-title":"Scand J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB59|cit59","doi-asserted-by":"crossref","first-page":"900","DOI":"10.3109\/00365528608996393","article-title":"Portal-systemic encephalopathy. Influence of shunt surgery and relations to serum amino acids","volume":"21","author":"Joelsson","year":"1986","journal-title":"Scand J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB60|cit60","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3109\/00365527809181755","article-title":"Encephalopathy in patients with cirrhosis of the liver. A neuropsychological study","volume":"13","author":"Elsass","year":"1978","journal-title":"Scand J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB61|cit61","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0168-8278(97)80290-5","article-title":"MRI findings in chronic hepatic encephalopathy depend on portosystemic shunt: results of a controlled prospective clinical investigation","volume":"27","author":"Krieger","year":"1997","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB62|cit62","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1002\/1097-4679(197701)33:1+<309::AID-JCLP2270330170>3.0.CO;2-N","article-title":"Wais functioning of cirrhotic and non-cirrhotic alcoholics","volume":"33","author":"Smith","year":"1977","journal-title":"J Clin Psychol"},{"key":"10.1002\/hep.510280508-BIB63|cit63","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1001\/archinte.1980.00330160079031","article-title":"Psychomotor performance defects in cirrhotic patients without overt encephalopathy","volume":"140","author":"Gilberstadt","year":"1980","journal-title":"Arch Intern Med"},{"key":"10.1002\/hep.510280508-BIB64|cit64","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1007\/BF01367675","article-title":"Latent portasystemic encephalopathy. I. Nature of cerebral functional defects and their effect on fitness to drive.","volume":"26","author":"Schomerus","year":"1981","journal-title":"Dig Dis Sci"},{"key":"10.1002\/hep.510280508-BIB65|cit65","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/S0016-5085(84)80154-7","article-title":"Nonalcoholic cirrhosis associated with neuropsychological dysfunction in the absence of overt evidence of hepatic encephalopathy","volume":"86","author":"Tarter","year":"1984","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510280508-BIB66|cit66","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0168-8278(86)80149-0","article-title":"The diagnosis and prevalence of subclinical hepatic encephalopathy in apparently healthy, ambulant, non-shunted patients with cirrhosis","volume":"3","author":"Gitlin","year":"1986","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB67|cit67","first-page":"156","article-title":"Comparative efficacy of psychometric tests in detection of subclinical hepatic encephalopathy in nonalcoholic cirrhotics: search for a rational approach","volume":"84","author":"Sood","year":"1989","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB68|cit68","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/0013-4694(84)90071-3","article-title":"Objective measurement of hepatic encephalopathy by means of automated EEG analysis","volume":"57","author":"Van der Rijt","year":"1984","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"10.1002\/hep.510280508-BIB69|cit69","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/0013-4694(90)90107-U","article-title":"Neurophysiological assessment of early hepatic encephalopathy","volume":"75","author":"Weissenborn","year":"1990","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"10.1002\/hep.510280508-BIB70|cit70","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/hep.510240316","article-title":"The diagnosis of subclinical hepatic encephalopathy in patients with cirrhosis using neuropsychological tests and automated electroencephalogram analysis","volume":"24","author":"Quero","year":"1996","journal-title":"Hepatology"},{"key":"10.1002\/hep.510280508-BIB71|cit71","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1136\/bmj.2.5710.633","article-title":"Method for measuring cerebral dysfunction in patients with liver disease","volume":"2","author":"Zeegen","year":"1970","journal-title":"Br Med J"},{"key":"10.1002\/hep.510280508-BIB72|cit72","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/0016-5085(78)90851-X","article-title":"Subclinical hepatic encephalopathy: detection, prevalence, and relationship to nitrogen metabolism","volume":"75","author":"Rikkers","year":"1978","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510280508-BIB73|cit73","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/BF01345296","article-title":"Prevalence of subclinical hepatic encephalopathy in cirrhotics and relationship to plasma amino acid imbalance","volume":"25","author":"Marchesini","year":"1980","journal-title":"Dig Dis Sci"},{"key":"10.1002\/hep.510280508-BIB74|cit74","first-page":"8","article-title":"Subclinical portal-systemic encephalopathy","volume":"83","author":"Gitlin","year":"1988","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB75|cit75","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/0168-8278(89)90140-2","article-title":"Neuropsychological deficits and morphological MRI brain scan abnormalities in apparently healthy non-encephalopatic patients with cirrhosis","volume":"9","author":"Moore","year":"1989","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB76|cit76","first-page":"610","article-title":"Untersuchungen zur Diagnose und Pr\u00e4valenz der latenten hepatischen Encephalopathie","volume":"28","author":"Koch","year":"1990","journal-title":"Z Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB77|cit77","first-page":"231","article-title":"Prevalence of latent portasystemic encephalopathy in an unselected population of patients with liver cirrhosis in general practice","volume":"31","author":"Schomerus","year":"1993","journal-title":"Z Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB78|cit78","first-page":"1059","article-title":"Diagnostik und Therapie der portosystemischen Enzephalopathie","volume":"83","author":"Weissenborn","year":"1994","journal-title":"Schweiz Rundsch Med"},{"key":"10.1002\/hep.510280508-BIB79|cit79","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/0168-8278(92)90046-R","article-title":"Interindividual variability of the number connection test [Letter]","volume":"15","author":"Zeneroli","year":"1992","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB80|cit80","first-page":"325","article-title":"The effect of lactulose on psychomotor performance tests in alcoholic cirrhotics without overt hepatic encephalopathy","volume":"6","author":"McClain","year":"1984","journal-title":"J Clin Gastroenterol"},{"key":"10.1002\/hep.510280508-BIB81|cit81","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/0168-8278(89)90009-3","article-title":"Lactitol and lactulose for the treatment of subclinical hepatic encephalopathy in cirrhotic patients","volume":"8","author":"Morgan","year":"1989","journal-title":"J Hepatol"},{"key":"10.1002\/hep.510280508-BIB82|cit82","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0016-5085(77)80135-2","article-title":"Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy","volume":"72","author":"Conn","year":"1977","journal-title":"Gastroenterology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.510280508","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-199811000-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T11:24:21Z","timestamp":1733052261000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-199811000-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,11]]},"references-count":82,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1998]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.510280508","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[1998,11]]}}}