{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:43:16Z","timestamp":1789983796409,"version":"4.0.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2012,11,21]],"date-time":"2012-11-21T00:00:00Z","timestamp":1353456000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p>Brain magnetic resonance (MR) study has shown metabolic abnormalities and changes in water distribution of the brain tissue that may relate to the pathogenesis of hepatic encephalopathy (HE). We designed a study to investigate the disturbances in brain water and metabolites during episodic HE using a 3-T MR scanner. Cirrhotic patients with different grades of HE underwent MR during hospitalization ( n = 18). The MR was repeated at 6 weeks' follow-up ( n = 14). The results were compared with those of a group of healthy volunteers ( n = 8). During episodic HE, brain diffusion-weighted imaging showed a high apparent diffusion coefficient (ADC) (12% to 14%) that decreased during follow-up (\u20131% to \u22124%). These disturbances were accompanied by high glutamine (581%), low choline (\u201331%), and low myo-inositol (\u201386%) peaks on MR spectroscopy. In overt HE, patients showed high glutamine that decreased during follow-up (\u201322%). In addition, these patients exhibited a rise in plasma S100 beta and enlargement of brain white-matter lesions. In conclusion, several disturbances detected by MR support the presence of impaired brain water homeostasis during episodic HE. Although astrocytes have a major role in this condition, brain edema during episodic HE may be extracellular and does not appear to be directly responsible for the development of neurologic manifestations.<\/jats:p>","DOI":"10.1038\/jcbfm.2012.173","type":"journal-article","created":{"date-parts":[[2012,11,21]],"date-time":"2012-11-21T04:01:55Z","timestamp":1353470515000},"page":"272-277","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":40,"title":["Brain Magnetic Resonance Spectroscopy in Episodic Hepatic Encephalopathy"],"prefix":"10.1177","volume":"33","author":[{"given":"Laia","family":"Chavarria","sequence":"first","affiliation":[{"name":"Liver Unit, Hospital Vall d'Hebron, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Departament de Medicina, Universitat Aut\u00f2noma 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