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Validation of a Paper and Pencil Test Battery for the Diagnosis of Minimal Hepatic Encephalopathy in Korea

Authors
Jeong, Jae YoonJun, Dae WonBai, DaisegKim, Ji YeanSohn, Joo HyunAhn, Sang BongKim, Sang GyuneKim, Tae YeobKim, Hyoung SuJeong, Soung WonCho, Yong KyunSong, Do SeonKim, Hee YeonJung, Young KulYoon, Eileen L.
Issue Date
9월-2017
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Minimal Hepatic Encephalopathy; Liver Cirrhosis; Psychometric Test; Cognitive Function
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.32, no.9, pp.1484 - 1490
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
32
Number
9
Start Page
1484
End Page
1490
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/82315
DOI
10.3346/jkms.2017.32.9.1484
ISSN
1011-8934
Abstract
The aim of this study was to validate a new paper and pencil test battery to diagnose minimal hepatic encephalopathy (MHE) in Korea. A new paper and pencil test battery was composed of number connection test-A (NCT-A), number connection test-B (NCT-B), digit span test (DST), and symbol digit modality test (SDMT). The norm of the new test was based on 315 healthy individuals between the ages of 20 and 70 years old. Another 63 healthy subjects (n=31) and cirrhosis patients (n= 32) were included as a validation cohort. All participants completed the new paper and pencil test, a critical flicker frequency (CFF) test and computerized cognitive function test (visual continuous performance test [CPT]). The scores on the NCT-A and NCT-B increased but those of DST and SDMT decreased according to age. Twelve of the cirrhotic patients (37.5%) were diagnosed with MHE based on the new paper and pencil test battery. The total score of the paper and pencil test battery showed good positive correlation with the CFF (r= 0.551, P< 0.001) and computerized cognitive function test. Also, this score was lower in patients with MHE compared to those without MHE (P< 0.001). Scores on the CFF (32.0 vs. 28.7 Hz, P= 0.028) and the computer base cognitive test decreased significantly in patients with MHE compared to those without MHE. Test-retest reliability was comparable. In conclusion, the new paper and pencil test battery including NCT-A, NCT-B, DST, and SDMT showed good correlation with neuropsychological tests. This new paper and pencil test battery could help to discriminate patients with impaired cognitive function in cirrhosis
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