Validation of a paper and pencil test battery for the diagnosis of minimal hepatic encephalopathy in Korea

Jae Yoon Jeong, Dae Won Jun, Daiseg Bai, Ji Yean Kim, Joo Hyun Sohn, Sang Bong Ahn, Sang Gyune Kim, Tae Yeob Kim, Hyoung Su Kim, Soung Won Jeong, Yong Kyun Cho, Do Seon Song, Hee Yeon Kim, Young Kul Jung, Eileen L. Yoon

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1484-1490
Number of pages7
JournalJournal of Korean medical science
Volume32
Issue number9
DOIs
Publication statusPublished - 2017 Sep 1

Keywords

  • Cognitive function
  • Liver cirrhosis
  • Minimal hepatic encephalopathy
  • Psychometric test

ASJC Scopus subject areas

  • Medicine(all)

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