Hepatitis C virus infection affects the brainevidence from psychometric studies and magnetic resonance spectroscopy
Karin Weissenborna*, Jochen Krausea, Martin Bokemeyerab, Hartmut Heckerc, Andreas Schülerd, Jochen C. Ennena, Björn Ahla, Michael P. Mannsd, Klaus W. Bökerd
Received 26 January 2004; received in revised form 19 July 2004; accepted 22 July 2004 published online 19 August 2004.
Background/Aims
Up to 50% of patients infected with the hepatitis C virus (HCV) complain of chronic fatigue and difficulties in concentration and memory. The aim of the present study was to seek evidence for the presence of central nervous system involvement in HCV infected patients with only mild liver disease.
Methods
Thirty HCV infected patients with normal liver function, 15 of whom were identified as having mild and 15 moderate to severe fatigue using the fatigue impact scale, underwent neurological and neuropsychological examination, electroencephalography (EEG) and cerebral proton magnetic resonance imaging (MRI) and spectroscopy (MRS). Fifteen healthy volunteers, matched for age and educational attainment, served as controls.
Results
In comparison to the healthy controls the patients with HCV infection showed evidence of cognitive impairment, primarily attention and higher executive functions, higher levels of anxiety and depression and impairment of quality of life. In addition they showed a significant decrease of the N-acetyl-aspartate/creatine ratio in the cerebral cortex on 1H MRS while the EEG was slowed in 25%. In general the deficits were more marked in the patients with moderate rather than mild fatigue.
Conclusions
The data provide evidence of central nervous system involvement in patients with HCV infection.
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