Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver.
Hepatology. 2014; 60: 715-735
Histological features of cerebellar neuropathology in patients with alcoholic and nonalcoholic steatohepatitis.
J Neuropathol Exp Neurol. 2018; 77: 837-845
Evidence for a cerebral effect of the hepatitis C virus.
Lancet. 2001; 358: 38-39
Magnetic resonance imaging evidence of hippocampal structural changes in patients with primary biliary cholangitis.
Clin Transl Gastroenterol. 2018; 9: 169
Early primary biliary cholangitis is characterised by brain abnormalities on cerebral magnetic resonance imaging.
Aliment Pharmacol Ther. 2016; 44: 936-945
Hepatic encephalopathy is associated with posttransplant cognitive function and brain volume.
Liver Transpl. 2011; 17: 38-46
Impact of preoperative overt hepatic encephalopathy on neurocognitive function after liver transplantation.
Liver Transpl. 2009; 15: 184-192
Increasing burden of hepatic encephalopathy among hospitalized adults: an analysis of the 2010-2014 National Inpatient Sample.
Dig Dis Sci. 2019; 64: 1448-1457
A quality improvement initiative reduces 30-day rate of readmission for patients with cirrhosis.
Clin Gastroenterol Hepatol. 2016; 14: 753-759
Characteristics, risk factors, and mortality of cirrhotic patients hospitalized for hepatic encephalopathy with and without acute-on-chronic liver failure (ACLF).
J Hepatol. 2014; 60: 275-281
Neurotransmitter dysfunction in hepatic encephalopathy: new approaches and new findings.
Metab Brain Dis. 2001; 16: 55-65
Impaired brain glymphatic flow in experimental hepatic encephalopathy.
J Hepatol. 2019; 70: 40-49
Cerebral blood flow and metabolism in hepatic encephalopathy-a meta-analysis.
J Clin Exp Hepatol. 2018; 8: 286-293
Hepatic encephalopathy and astrocyte senescence.
J Clin Exp Hepatol. 2018; 8: 294-300
Cerebrospinal fluid metabolomics highlights dysregulation of energy metabolism in overt hepatic encephalopathy.
J Hepatol. 2016; 65: 1120-1130
Hepatic encephalopathy is associated with decreased cerebral oxygen metabolism and blood flow, not increased ammonia uptake.
Hepatology. 2013; 57: 258-265
Hepatic encephalopathy is linked to alterations of autophagic flux in astrocytes.
EBioMedicine. 2019; 48: 539-553
Incidence of and risk factors for hepatic encephalopathy in a population-based cohort of Americans with cirrhosis.
Hepatol Commun. 2019; 3: 1510-1519
A 20-year prospective study of cirrhosis.
Br Med J (Clin Res Ed). 1981; 282: 263-266
Clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study.
Hepatology. 2010; 51: 1675-1682
Survival and prognostic indicators in compensated and decompensated cirrhosis.
Dig Dis Sci. 1986; 31: 468-475
Portosystemic hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: clinical, laboratory, psychometric, and electroencephalographic investigations.
Hepatology. 1998; 28: 1215-1225
Incidence of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) according to its severity and temporal grading classification.
Radiol Med. 2017; 122: 713-721
Critical flicker frequency and continuous reaction times for the diagnosis of minimal hepatic encephalopathy: a comparative study of 154 patients with liver disease.
Metab Brain Dis. 2011; 26: 135-139
Value of the critical flicker frequency in patients with minimal hepatic encephalopathy.
Hepatology. 2007; 45: 879-885
Diagnosis of minimal hepatic encephalopathy using Stroop EncephalApp: a multicenter US-based, norm-based study.
Am J Gastroenterol. 2016; 111: 78-86
Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis.
Am J Gastroenterol. 2009; 104: 1382-1389
Diabetes as a risk factor for hepatic encephalopathy in cirrhosis patients.
J Hepatol. 2015; 63: 1133-1138
Diagnosis of covert hepatic encephalopathy: a multi-center study testing the utility of single versus combined testing.
Metab Brain Dis. 2018; 34: 289-295
Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo.
Gastroenterology. 2009; 137 (): 885-891
Rifaximin treatment in hepatic encephalopathy.
N Engl J Med. 2010; 362: 1071-1081
Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy.
Hepatology. 2007; 45: 549-559
Burden of illness and economic model for patients with nonalcoholic steatohepatitis in the United States.
Hepatology. 2019; 69: 564-572
Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United States.
Liver Int. 2019; 39: 878-884
Overt hepatic encephalopathy in Italy: clinical outcomes and healthcare costs.
Hepatic Med Evid Res. 2015; 7: 37-42
Hospitalizations due to cirrhosis: clinical aspects in a large cohort of Italian patients and cost analysis report.
Dig Dis. 2017; 35: 433-438
The multi-dimensional burden of cirrhosis and hepatic encephalopathy on patients and caregivers.
Am J Gastroenterol. 2011; 106: 1646-1653
Hepatic encephalopathy–definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998.
Hepatology. 2002; 35: 716-721
Assessment of the spectrum of hepatic encephalopathy: a multicenter study.
Liver Transpl. 2018; 24: 587-594
Performance of the hepatic encephalopathy scoring algorithm in a clinical trial of patients with cirrhosis and severe hepatic encephalopathy.
Am J Gastroenterol. 2009; 104: 1392-1400
Randomized, double-blind, controlled study of glycerol phenylbutyrate in hepatic encephalopathy.
Hepatology. 2014; 59: 1073-1083
Overt hepatic encephalopathy: development of a novel clinician reported outcome tool and electronic caregiver diary.
Metab Brain Dis. 2016; 31: 1081-1093
Review article: the design of clinical trials in hepatic encephalopathy–an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement.
Aliment Pharmacol Ther. 2011; 33: 739-747
Covert hepatic encephalopathy: agreement and predictive validity of different indices.
World J Gastroenterol. 2014; 20: 15756-15762
Clinical and pathophysiological characteristics of cirrhotic patients with grade 1 and minimal hepatic encephalopathy.
PLoS One. 2016; 11: e0146076
Testing for minimal hepatic encephalopathy in the United States: an AASLD survey.
Hepatology. 2007; 45: 833-834
Neuropsychiatric performance in patients with cirrhosis: who is “normal”?.
J Hepatol. 2017; 66: 825-835
Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial.
Gastroenterology. 1977; 72: 573-583
Role of ammonia, inflammation, and cerebral oxygenation in brain dysfunction of acute-on-chronic liver failure patients.
Liver Transpl. 2016; 22: 732-742
In vivo 1H magnetic resonance spectroscopy-derived metabolite variations between acute-on-chronic liver failure and acute liver failure.
Liver Int. 2008; 28: 1095-1103
Role of predisposition, injury, response and organ failure in the prognosis of patients with acute-on-chronic liver failure: a prospective cohort study.
Crit Care. 2012; 16: R227
Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis.
Gastroenterology. 2013; 144 (): 1426-1437
Acute-on-chronic liver failure.
N Engl J Med. 2020; 382: 2137-2145
Quantitative cerebral water content mapping in hepatic encephalopathy.
Neuroimage. 2008; 41: 706-717
Brain magnetic resonance spectroscopy in episodic hepatic encephalopathy.
J Cereb Blood Flow Metab. 2013; 33: 272-277
Brain edema dynamics in patients with overt hepatic encephalopathy A magnetic resonance imaging study.
Neuroimage. 2010; 52: 481-487
Cerebral water content mapping in cirrhosis patients with and without manifest HE.
Metab Brain Dis. 2019; 34: 1071-1076
Cerebral oedema is rare in acute-on-chronic liver failure patients presenting with high-grade hepatic encephalopathy.
Liver Int. 2014; 34: 362-366
Reduction in hyperammonaemia by ornithine phenylacetate prevents lipopolysaccharide-induced brain edema and coma in cirrhotic rats.
Liver Int. 2012; 32: 410-419
Endotoxemia produces coma and brain swelling in bile duct ligated rats.
Hepatology. 2007; 45: 1517-1526
Ammonia reduction with ornithine phenylacetate restores brain eNOS activity via the DDAH-ADMA pathway in bile duct-ligated cirrhotic rats.
Am J Physiol Gastrointest Liver Physiol. 2012; 302: G145-G152
NACSELD acute-on-chronic liver failure (NACSELD-ACLF) score predicts 30-day survival in hospitalized patients with cirrhosis.
Hepatology. 2018; 67: 2367-2374
Diencephalic and cerebellar pathology in alcoholic and nonalcoholic patients with end-stage liver disease.
Hepatology. 1997; 26: 837-841
Minimal/covert hepatic encephalopathy – impact of comorbid conditions.
J Clin Exp Hepatol. 2019; 9: 109-111
The negative association of childhood obesity to cognitive control of action monitoring.
Cereb Cortex. 2014; 24: 654-662
The relationship between executive function and obesity in children and adolescents: a systematic literature review.
J Obes. 2013; 2013: 820956
Association of nonalcoholic fatty liver disease with lower brain volume in healthy middle-aged adults in the Framingham study.
JAMA Neurol. 2018; 75: 97-104
Cognitive changes and brain volume reduction in patients with nonalcoholic fatty liver disease.
Can J Gastroenterol Hepatol. 2018; 2018: 9638797
Nonalcoholic fatty liver disease and measures of early brain health in middle-aged adults: the CARDIA study.
Obesity (Silver Spring). 2017; 25: 642-651
Urea cycle dysregulation in non-alcoholic fatty liver disease.
J Hepatol. 2018; 69: 905-915
Nonalcoholic fatty liver disease is associated with cognitive function in adults.
Neurology. 2016; 86: 1136-1142
Non-alcoholic fatty liver disease, liver fibrosis score and cognitive function in middle-aged adults: the Framingham Study.
Liver Int. 2019; 39: 1713-1721
Cerebral microglial activation in patients with hepatitis C: in vivo evidence of neuroinflammation.
J Viral Hepat. 2012; 19: e89-e96
Malnutrition and diabetes mellitus are related to hepatic encephalopathy in patients with liver cirrhosis.
Liver Int. 2007; 27: 1194-1201
Analysis of prognostic variables in the prediction of mortality, shunt failure, variceal rebleeding and encephalopathy following the transjugular intrahepatic portosystemic stent-shunt for variceal haemorrhage.
J Hepatol. 1995; 23: 123-128
Cognitive performance as a predictor of hepatic encephalopathy in pretransplant patients with cirrhosis receiving psychoactive medications: a prospective study.
Liver Transpl. 2012; 18: 1179-1187
Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi-centre cohort.
Aliment Pharmacol Ther. 2019; 49: 1518-1527
A risk score to predict the development of hepatic encephalopathy in a population-based cohort of patients with cirrhosis.
Hepatology. 2018; 68: 1498-1507
Benzodiazepines and risk for hepatic encephalopathy in patients with cirrhosis and ascites.
United Eur Gastroenterol J. 2018; 6: 407-412
Ammonia-induced senescence in cultured rat astrocytes and in human cerebral cortex in hepatic encephalopathy.
Glia. 2015; 63: 37-50
Brain metabolism of 13N-ammonia during acute hepatic encephalopathy in cirrhosis measured by positron emission tomography.
Hepatology. 2006; 43: 42-50
Interorgan ammonia metabolism in liver failure: the basis of current and future therapies.
Liver Int. 2011; 31: 163-175
Identifying the direct effects of ammonia on the brain.
Metab Brain Dis. 2009; 24: 95-102
Ammonia toxicity: from head to toe?.
Metab Brain Dis. 2017; 32: 529-538
Hyperammonaemia-induced skeletal muscle mitochondrial dysfunction results in cataplerosis and oxidative stress.
J Physiol (Lond). 2016; 594: 7341-7360
Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013.
J Hepatol. 2014; 60: 1310-1324
Free radicals in the physiological control of cell function.
Physiol Rev. 2002; 82: 47-95
Oxidative stress markers in the brain of patients with cirrhosis and hepatic encephalopathy.
Hepatology. 2010; 52: 256-265
Systemic oxidative stress is implicated in the pathogenesis of brain edema in rats with chronic liver failure.
Free Radic Biol Med. 2012; 52: 1228-1235
Systemic inflammatory response exacerbates the neuropsychological effects of induced hyperammonemia in cirrhosis.
J Hepatol. 2004; 40: 247-254
Infection and systemic inflammation, not ammonia, are associated with grade 3/4 hepatic encephalopathy, but not mortality in cirrhosis.
J Hepatol. 2011; 54: 640-649
3-Nitro-Tyrosine as a peripheral biomarker of minimal hepatic encephalopathy in patients with liver cirrhosis.
Am J Gastroenterol. 2011; 106: 1629-1637
Induction of systemic oxidative stress leads to brain oedema in portacaval shunted rats.
Liver Int. 2014; 34: 1322-1329
Bile acids content in brain of common duct ligated rats.
Ann Hepatol. 2012; 11: 930-934
Bile acid-mediated Sphingosine-1-Phosphate receptor 2 signaling promotes neuroinflammation during hepatic encephalopathy in mice.
Front Cell Neurosci. 2017; 11: 191
Manganese deposition in basal ganglia structures results from both portal-systemic shunting and liver dysfunction.
Gastroenterology. 1999; 117: 640-644
MR imaging findings in hepatic encephalopathy.
AJNR Am J Neuroradiol. 2008; 29: 1612-1621
Serum sodium as a risk factor for hepatic encephalopathy in patients with cirrhosis and ascites.
J Gastroenterol Hepatol. 2019; 34: 914-920
Improvement of hyponatremia in cirrhosis is associated with improved complex information processing.
J Gastroenterol Hepatol. 2019; 34: 1999-2003
Satavaptan treatment for ascites in patients with cirrhosis: a meta-analysis of effect on hepatic encephalopathy development.
Metab Brain Dis. 2013; 28: 301-305
Correction of hyponatraemia improves cognition, quality of life, and brain oedema in cirrhosis.
J Hepatol. 2015; 62: 75-82
Neurosteroids in hepatic encephalopathy: novel insights and new therapeutic opportunities.
J Steroid Biochem Mol Biol. 2016; 160: 94-97
Roles of glutamate and glutamine transport in ammonia neurotoxicity: state of the art and question marks.
Endocr Metab Immune Disord Drug Targets. 2018; 18: 306-315
Increased brain lactate is central to the development of brain edema in rats with chronic liver disease.
J Hepatol. 2014; 60: 554-560
Interplay between glutamatergic and GABAergic neurotransmission alterations in cognitive and motor impairment in minimal hepatic encephalopathy.
Neurochem Int. 2015; 88: 15-19
Oxidative metabolism of astrocytes is not reduced in hepatic encephalopathy: a PET study with [(11)C]acetate in humans.
Front Neurosci. 2014; 8: 353
Novel insights into ammonia-mediated neurotoxicity pointing to potential new therapeutic strategies.
Hepatology. 2014; 60: 1101-1103
Postoperative cognitive dysfunction after liver transplantation.
Gen Hosp Psychiatry. 2015; 37: 109-115
Cognitive impairment and electroencephalographic alterations before and after liver transplantation: what is reversible?.
Liver Transpl. 2014; 20: 977-986
Reversibility of hepatic encephalopathy after liver transplantation.
Metab Brain Dis. 2010; 25: 111-113
Neurological complications after orthotopic liver transplantation.
Dig Liver Dis. 2007; 39: 740-747
EFNS guidelines on management of neurological problems in liver transplantation.
Eur J Neurol. 2006; 13: 2-9
Persistence of cognitive impairment after resolution of overt hepatic encephalopathy.
Gastroenterology. 2010; 138: 2332-2340
Evidence of persistent cognitive impairment after resolution of overt hepatic encephalopathy.
Clin Gastroenterol Hepatol. 2011; 9: 181-183
Reversal of low-grade cerebral edema after lactulose/rifaximin therapy in patients with cirrhosis and minimal hepatic encephalopathy.
Clin Trans Gastroenterol. 2015; 6: e111
Cerebellar neurodegeneration in a new rat model of episodic hepatic encephalopathy.
J Cereb Blood Flow Metab. 2017; 37: 927-937
The human gut microbiome in liver diseases.
Semin Liver Dis. 2017; 37: 128-140
The microbiome-gut-brain axis in health and disease.
Gastroenterol Clin North Am. 2017; 46: 77-89
The NIH Human Microbiome Project.
Genome Res. 2009; 19: 2317-2323
Diversity of the autochthonous colonic microbiota.
Gut Microbes. 2011; 2: 99-104
Systemic inflammation and ammonia in hepatic encephalopathy.
Metab Brain Dis. 2013; 28: 1-5
Characterization of fecal microbial communities in patients with liver cirrhosis.
Hepatology. 2011; 54: 562-572
Alterations of the human gut microbiome in liver cirrhosis.
Nature. 2014; 513: 59-64
Altered profile of human gut microbiome is associated with cirrhosis and its complications.
J Hepatol. 2014; 60: 940-947
Dysbiosis of small intestinal microbiota in liver cirrhosis and its association with etiology.
Sci Rep. 2016; 6: 34055
Salivary microbiota reflects changes in gut microbiota in cirrhosis with hepatic encephalopathy.
Hepatology. 2015; 62: 1260-1271
Alteration of the serum microbiome composition in cirrhotic patients with ascites.
Sci Rep. 2016; 6: 25001
Unique subgingival microbiota associated with periodontitis in cirrhosis patients.
Sci Rep. 2018; 8: 10718
Modulation of the fecal bile acid profile by gut microbiota in cirrhosis.
J Hepatol. 2013; 58: 949-955
Gut dysbiosis in acute-on-chronic liver failure and its predictive value for mortality.
J Gastroenterol Hepatol. 2015; 30: 1429-1437
Gut microbiota alterations can predict hospitalizations in cirrhosis independent of diabetes mellitus.
Sci Rep. 2015; 5: 18559
Fungal dysbiosis in cirrhosis.
Gut. 2017; 67: 1146-1154
The nutritional management of hepatic encephalopathy in patients with cirrhosis: International society for hepatic encephalopathy and nitrogen metabolism consensus.
Hepatology. 2013; 58: 325-336
Nocturnal nutritional supplementation improves total body protein status of patients with liver cirrhosis: a randomized 12-month trial.
Hepatology. 2008; 48: 557-566
Normal protein diet for episodic hepatic encephalopathy: results of a randomized study.
J Hepatol. 2004; 41: 38-43
Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value.
Liver Transpl. 2012; 18: 1209-1216
Decreased muscle strength in patients with alcoholic liver cirrhosis in relation to nutritional status, alcohol abstinence, liver function, and neuropathy.
Hepatology. 1998; 27: 1200-1206
Muscle wasting is associated with mortality in patients with cirrhosis.
Clin Gastroenterol Hepatol. 2012; 10: 166-173
Sarcopenia is risk factor for development of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt placement.
Clin Gastroenterol Hepatol. 2017; 15: 934-936
The modification of quantity and quality of muscle mass improves the cognitive impairment after TIPS.
Liver Int. 2019; 39: 871-877
Myosteatosis and sarcopenia are associated with hepatic encephalopathy in patients with cirrhosis.
Hepatol Int. 2018; 12: 377-386
Sarcopenia predicts minimal hepatic encephalopathy in patients with liver cirrhosis.
Hepatol Res. 2017; 47: 1359-1367
Muscle depletion increases the risk of overt and minimal hepatic encephalopathy: results of a prospective study.
Metab Brain Dis. 2013; 28: 281-284
Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis.
Hepatology. 2017; 65: 2045-2058
Sex differences in the association between frailty and sarcopenia in patients with cirrhosis.
Clin Transl Gastroenterol. 2019; 10: e00102
Multicenter study of age, frailty, and waitlist mortality among liver transplant candidates.
Ann Surg. 2020; 271: 1132-1136
Neuropsychiatric complications of liver transplantation.
Metab Brain Dis. 2001; 16: 3-11
Neurological complications occurring after liver transplantation: role of risk factors, hepatic encephalopathy, and acute (on chronic) brain injury.
Liver Transpl. 2019; 25: 469-487
Donor age predicts calcineurin inhibitor induced neurotoxicity after liver transplantation.
Transplantation. 2019; 103: e211-e215
Hepatic encephalopathy is reversible in the long term after liver transplantation.
Liver Transpl. 2019; 25: 1661-1672
Current and future applications of magnetic resonance imaging and spectroscopy of the brain in hepatic encephalopathy.
World J Gastroenterol. 2006; 12: 2969-2978
New technologies – new insights into the pathogenesis of hepatic encephalopathy.
Metab Brain Dis. 2016; 31: 1259-1267
Changes in brain size in hepatic encephalopathy: a coregistered MRI study.
Metab Brain Dis. 2004; 19: 431-445
MR imaging of the basal ganglia in chronic liver disease: correlation of T1-weighted and magnetisation transfer contrast measurements with liver dysfunction and neuropsychiatric status.
Metab Brain Dis. 1995; 10: 175-188
1H-MR spectroscopy, magnetization transfer, and diffusion-weighted imaging in alcoholic and nonalcoholic patients with cirrhosis with hepatic encephalopathy.
AJNR Am J Neuroradiol. 2006; 27: 1019-1026
Modulation of neural activation following treatment of hepatic encephalopathy.
Neurology. 2013; 80: 1041-1047
Proton MR spectroscopic measurement of neurometabolites in hepatic encephalopathy during oral lactulose therapy.
AJNR Am J Neuroradiol. 1998; 19: 1681-1686
Cerebral phosphorus-31 magnetic resonance spectroscopy in patients with chronic hepatic encephalopathy.
Hepatology. 1994; 20: 1173-1178
Brain edema: a valid endpoint for measuring hepatic encephalopathy?.
Metab Brain Dis. 2016; 31: 1249-1258
Magnetic resonance imaging and spectroscopy in hepatic encephalopathy.
J Clin Exp Hepatol. 2015; 5: S69-S74
New spectral thresholds improve the utility of the electroencephalogram for the diagnosis of hepatic encephalopathy.
Clin Neurophysiol. 2016; 127: 2933-2941
Increased availability of central benzodiazepine receptors in patients with chronic hepatic encephalopathy and alcohol related cirrhosis.
Gut. 2000; 46: 546-552
Systematic review with meta-analysis: the effects of rifaximin in hepatic encephalopathy.
Aliment Pharmacol Ther. 2014; 40: 123-132
Radiotracer imaging studies in hepatic encephalopathy: ISHEN practice guidelines.
Liver Int. 2009; 29: 621-628
Duration of the acute hepatic encephalopathy episode determines survival in cirrhotic patients.
Therap Adv Gastroenterol. 2018; 11 ()
Clinical impact of arterial ammonia levels in ICU patients with different liver diseases.
Intensive Care Med. 2013; 39: 1227-1237
Cerebral herniation in patients with acute liver failure is correlated with arterial ammonia concentration.
Hepatology. 1999; 29: 648-653
Predictive value of arterial ammonia for complications and outcome in acute liver failure.
Gut. 2006; 55: 98-104
Arterial ammonia and clinical risk factors for encephalopathy and intracranial hypertension in acute liver failure.
Hepatology. 2007; 46: 1844-1852
Correlation between ammonia levels and the severity of hepatic encephalopathy.
Am J Med. 2003; 114: 188-193
Persistent hyperammonemia is associated with complications and poor outcomes in patients with acute liver failure.
Clin Gastroenterol Hepatol. 2012; 10: 925-931
Role of determination of partial pressure of ammonia in cirrhotic patients with and without hepatic encephalopathy.
J Hepatol. 2003; 38: 441-446
Serum ammonia in associated with transplant-free survival in hospitalized patients with acutely decompensated cirrhosis.
J Clin Gastroenterol. 2016; 50: 345-350
Prognostic role of ammonia in patients with cirrhosis.
Hepatology. 2019; 70: 982-994
Fasting blood ammonia predicts risk and frequency of hepatic encephalopathy episodes in patients with cirrhosis.
Clin Gastroenterol Hepatol. 2016; 14: 903-906.e1
Pharmacotherapies that specifically target ammonia for the prevention and treatment of hepatic encephalopathy in adults with cirrhosis.
Cochrane Database Syst Rev. 2019; 6: CD012334
Oral glutamine challenge is a marker of altered ammonia metabolism and predicts the risk of hepatic encephalopathy.
Liver Int. 2019; 40: 921-930
Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis.
Cochrane Database Syst Rev. 2016; 4: CD003044
Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis.
Hepatology. 2007; 46: 1853-1862
Variability and lability of ammonia levels in healthy volunteers and patients with cirrhosis: implications for trial design and clinical practice.
Am J Gastroenterol. 2020; 115: 783-785
Elevated ammonia concentrations: potential for pre-analytical and analytical contributing factors.
Clin Biochem. 2014; 47: 233-236
STOP-HE: a randomized, double-blind, placebo-controlled study of OCR-002 in patients with hepatic encephalopathy.
Hepatology. 2017; 66: 276A
A capillary blood ammonia bedside test following glutamine load to improve the diagnosis of hepatic encephalopathy in cirrhosis.
BMC Gastroenterol. 2011; 11: 134
Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy.
Am J Physiol Gastrointest Liver Physiol. 2009; 296: G330-G338
Significant reduction in heart rate variability is a feature of acute decompensation of cirrhosis and predicts 90-day mortality.
Aliment Pharmacol Ther. 2019; 50: 568-579
The animal naming test: an easy tool for the assessment of hepatic encephalopathy.
Hepatology. 2017; 66: 198-208
Assessment of the technical usability and efficacy of a new portable dry-electrode EEG recorder: first results of the HOMEONE study.
Clin Neurophysiol. 2019; 130: 2076-2087
Ammonia-lowering strategies for the treatment of hepatic encephalopathy.
Clin Pharmacol Ther. 2012; 92: 321-331
A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy.
Metab Brain Dis. 2012; 27: 205-215
Lactulose vs polyethylene glycol 3350–electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial.
JAMA Intern Med. 2014; 174: 1727-1733
Modulation of the metabiome by rifaximin in patients with cirrhosis and minimal hepatic encephalopathy.
PLoS One. 2013; 8: e60042
Review article: the antimicrobial effects of rifaximin on the gut microbiota.
Aliment Pharmacol Ther. 2015; 43: 3-10
Rifaximin has minor effects on bacterial composition, inflammation, and bacterial translocation in cirrhosis: a randomized trial.
J Gastroenterol Hepatol. 2018; 33: 307-314
Comparison of rifaximin and lactitol in the treatment of acute hepatic encephalopathy: results of a randomized, double-blind, double-dummy, controlled clinical trial.
J Hepatol. 2003; 38: 51-58
Rifaximin, a non-absorbable rifamycin, for the treatment of hepatic encephalopathy. A double-blind, randomised trial.
Curr Med Res Opin. 1997; 13: 593-601
Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy: a prospective randomized study.
Yonsei Med J. 2005; 46: 399-407
Rifaximin versus nonabsorbable disaccharides in the management of hepatic encephalopathy: a meta-analysis.
Eur J Gastroenterol Hepatol. 2008; 20: 1064-1070
Rifaximin vs conventional oral therapy for hepatic encephalopathy: a meta-analysis.
World J Gastroenterol. 2012; 18: 767-777
Double-blind, double-dummy comparison between treatment with rifaximin and lactulose in patients with medium to severe degree hepatic encephalopathy.
Curr Med Res Opin. 1993; 13: 109-118
A randomized, double-blind, controlled trial comparing rifaximin plus lactulose with lactulose alone in treatment of overt hepatic encephalopathy.
Am J Gastroenterol. 2013; 108: 1458-1463
Probiotics for people with hepatic encephalopathy.
Cochrane Database Syst Rev. 2017; 2: CD008716
Branched-chain amino acids for people with hepatic encephalopathy.
Cochrane Database Syst Rev. 2017; 5: CD001939
L-ornithine-L-aspartate for hepatic encephalopathy in patients with cirrhosis: a meta-analysis of randomized controlled trials.
J Gastroenterol Hepatol. 2013; 28: 783-792
Efficacy of l-ornithine l-aspartate for the treatment of hepatic encephalopathy and hyperammonemia in cirrhosis: systematic review and meta-analysis of randomized controlled trials.
J Clin Exp Hepatol. 2018; 8: 301-313
L-Ornithine L-Aspartate (LOLA) for hepatic encephalopathy in cirrhosis: results of randomized controlled trials and meta-analyses.
Drugs. 2019; 79: 31-37
L-ornithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis.
Cochrane Database Syst Rev. 2018; 5: CD012410
Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: a multicenter survey on safety and efficacy.
Hepatology. 2013; 57: 2448-2457
Portosystemic shunt embolization and recurrent ascites: a single-center case series.
Gastroenterology. 2018; 155: 1649-1650
Effects of intravenous albumin in patients with cirrhosis and episodic hepatic encephalopathy: a randomized double-blind study.
J Hepatol. 2013; 59: 1184-1192
Randomized controlled trial comparing lactulose plus albumin versus lactulose alone for treatment of hepatic encephalopathy.
J Gastroenterol Hepatol. 2017; 32: 1234-1239
Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial.
Hepatology. 2013; 57: 1153-1162
Enhanced renal ammonia excretion following volume expansion in patients with well compensated cirrhosis of the liver.
Gut. 2003; 52: 1041-1045
Ammonia clearance with haemofiltration in adults with liver disease.
Liver Int. 2014; 34: 42-48
Primary prophylaxis of overt hepatic encephalopathy in patients with cirrhosis: an open labeled randomized controlled trial of lactulose versus no lactulose.
J Gastroenterol Hepatol. 2012; 27: 1329-1335
Probiotics prevent hepatic encephalopathy in patients with cirrhosis: a randomized controlled trial.
Clin Gastroenterol Hepatol. 2014; 12: 1003-1008.e1
Comparative effectiveness of different pharmacological interventions for the treatment of minimal hepatic encephalopathy: a systematic review with network meta-analysis.
Hepatology. 2016; 64: 711A
Secondary prophylaxis of hepatic encephalopathy in cirrhosis: an open-label, randomized controlled trial of lactulose, probiotics, and no therapy.
Am J Gastroenterol. 2012; 107: 1043-1050
Rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy.
Clin Gastroenterol Hepatol. 2014; 12: 1390-1397.e2
Probiotic VSL#3 reduces liver disease severity and hospitalization in patients with cirrhosis: a randomized, controlled trial.
Gastroenterology. 2014; 147: 1327-1337.e3
Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial.
Lancet. 2018; 391: 2417-2429
L-Ornithine phenylacetate (OP): a novel treatment for hyperammonemia and hepatic encephalopathy.
Med Hypotheses. 2007; 69: 1064-1069
L-Ornithine phenylacetate reduces ammonia in pigs with acute liver failure through phenylacetylglycine formation: a novel ammonia-lowering pathway.
Am J Physiol Gastrointest Liver Physiol. 2014; 307: G1024-G1031
L-ornithine phenylacetate attenuates increased arterial and extracellular brain ammonia and prevents intracranial hypertension in pigs with acute liver failure.
Hepatology. 2009; 50: 165-174
Ornithine phenylacetate prevents disturbances of motor-evoked potentials induced by intestinal blood in rats with portacaval anastomosis.
J Hepatol. 2012; 56: 109-114
OCR-002 (ornithine phenylacetate) is a potent ammonia scavenger as demonstrated in phase 2b STOP-HE study.
Hepatology. 2017; 66: 126A
Treating hepatic encephalopathy in cirrhotic patients admitted to ICU with sodium phenylbutyrate: a preliminary study.
Fundam Clin Pharmacol. 2018; 32: 209-215
Fecal microbiota transplantation in the management of hepatic encephalopathy.
Hepatology. 2016; 63: 339-340
Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: a randomized clinical trial.
Hepatology. 2017; 66: 1727-1738
Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: a randomized clinical trial.
Hepatology. 2017; 66: 1354-1355
Liposome-supported peritoneal dialysis for the treatment of hyperammonemia-associated encephalopathy.
Adv Funct Mater. 2016; 26: 8382-8389
An engineered E. coli nissle improves hyperammonemia and survival in mice and shows dose-dependent exposure in healthy humans.
Sci Transl Med. 2019; 11: eaau7975
Synlogic Discontinues Development of SYNB1020 to Treat Hyperammonemia. Synlogic n.d. Available at: https://investor.synlogictx.com/news-releases/news-release-details/synlogic-discontinues-development-synb1020-treat-hyperammonemia. [Accessed October 23, 2019].
AST-120 (spherical carbon adsorbent) lowers ammonia levels and attenuates brain edema in bile-duct ligated rats.
Hepatology. 2011; 53: 1995-2002
GR3027 antagonizes GABAA receptor-potentiating neurosteroids and restores spatial learning and motor coordination in rats with chronic hyperammonemia and hepatic encephalopathy.
Am J Physiol Gastrointest Liver Physiol. 2015; 309: G400-G409
GABAA receptor modulating steroid antagonists (GAMSA) are functional in vivo.
J Steroid Biochem Mol Biol. 2016; 160: 98-105
Modulation of GABAA receptors by neurosteroids. A new concept to improve cognitive and motor alterations in hepatic encephalopathy.
J Steroid Biochem Mol Biol. 2016; 160: 88-93
Effect of portacaval anastomosis on glutamine synthetase protein and gene expression in brain, liver and skeletal muscle.
Metab Brain Dis. 1999; 14: 273-280
Ornithine phenylacetate targets alterations in the expression and activity of glutamine synthase and glutaminase to reduce ammonia levels in bile duct ligated rats.
J Hepatol. 2014; 60: 545-553
Direct molecular and spectroscopic evidence for increased ammonia removal capacity of skeletal muscle in acute liver failure.
J Hepatol. 2006; 44: 1083-1088
Hyperammonemia in gene-targeted mice lacking functional hepatic glutamine synthetase.
Proc Natl Acad Sci U S A. 2015; 112: 5521-5526
Pivotal role of glutamine synthetase in ammonia detoxification.
Hepatology. 2017; 65: 281-293
Delivery of glutamine synthetase gene by baculovirus vectors: a proof of concept for the treatment of acute hyperammonemia.
Gene Ther. 2015; 22: 58-64
Recombinant glutamine synthetase: a novel strategy for the treatment of hyperammonemia and consequent hepatic encephalopathy in rodent model of cirrhosis and urea cycle enzyme deficiency.
J Hepatol. 2019; 70: e93-e94
Hepatic encephalopathy in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure.
J Hepatol. 2015; 62: 437-447
The continuous reaction time test for minimal hepatic encephalopathy validated by a randomized controlled multi-modal intervention-A pilot study.
PLoS One. 2017; 12: e0185412
Inhibitory control test for the diagnosis of minimal hepatic encephalopathy.
Gastroenterology. 2008; 135: 1591-1600.e1
Simple tools for complex syndromes: a three-level difficulty test for hepatic encephalopathy.
Dig Liver Dis. 2012; 44: 957-960
Electroencephalography in patients with cirrhosis.
Gastroenterology. 2011; 141 (): 1680-1689
Value of critical flicker frequency and psychometric hepatic encephalopathy score in diagnosis of low-grade hepatic encephalopathy.
Gastroenterology. 2014; 146: 961-969.e11
Brain metabolism in patients with hepatic encephalopathy studied by PET and MR.
Arch Biochem Biophys. 2013; 536: 131-142
Risk of recurrent hepatic encephalopathy in patients with liver cirrhosis: a German registry study.
Eur J Gastroenterol Hepatol. 2020; https://doi.org/10.1097/MEG.0000000000001822
Quantitative magnetic resonance imaging in patients with cirrhosis: a cross-sectional study.
Metab Brain Dis. 2016; 31: 1315-1325
Serum zinc concentrations in two cohorts of 153 healthy subjects and 100 cirrhotic patients from Mexico City.
Dig Dis. 1995; 13: 136-142
Clinical trial: oral zinc in hepatic encephalopathy.
Aliment Pharmacol Ther. 2010; 32: 1080-1090