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01-06-2009 | Original Paper

Mammillary body atrophy in acute liver failure and acute-on-chronic liver failure of nonalcoholic etiology

Authors: Pranav Kumar Mandal, Santosh Kumar Yadav, Vivek Anand Saraswat, Jitesh Kumar Singh, Pooja Upreti, Rajendra Singh, Ram Kishore Singh Rathore, Rakesh Kumar Gupta

Published in: Metabolic Brain Disease | Issue 2/2009

Abstract

The most common cause of atrophy of mammillary bodies (MBs) is thiamine deficiency, which is very common in patients with alcoholic liver disease. The purpose of this study was to look for changes in MBs using brain magnetic resonance imaging (MRI) in patients with acute liver failure (ALF), acute-on-chronic liver failure (ACLF) and chronic liver failure (CLF) of non-alcoholic etiology. Volumes of MBs and caudate nuclei (CNs) were quantified in nine patients with ALF, 17 with ACLF, 18 with CLF and in 24 healthy controls. Volume of these structures was quantified again three weeks after clinical recovery in five patients with ALF who had survived their illness. Volume of left, right and both MBs was significantly decreased (p < 0.05) in patients with ALF and ACLF whereas there was no change in patients with CLF, when compared with healthy controls. However CN volumes did not change significantly compared to controls in any of the three patient groups. In the follow-up study significant recovery in volume of MBs was noted compared to baseline values in the ALF patients. We conclude that significant volume loss occurs in MBs in patients with ALF and ACLF of non-alcoholic etiology but not in CLF. This loss of MBs volume recovers substantially in patients with ALF who survive their illness.

Allen GV, Hopkins DA (1988) Mammillary body in the rat: a cytoarchitectonic, Golgi and ultra structural study. J Comp Neurol 275:39–64PubMedCrossRef

Antunez E, Estruch R, Cardenal C et al (1998) Usefulness of CT and MR imaging in the diagnosis of acute Wernicke’s encephalopathy. Am J Roentgenol 171:1131–1137

Atterbury CE, Maddrey WC, Conn HO (1978) Neomycin-sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy: a controlled, double-blind clinical trial. Am J Dig Dis 23:398–406PubMedCrossRef

Bae SJ, Lee HK, Lee JH et al (2001) Wernicke’s encephalopathy: Atypical manifestation at MR imaging. Am J Neuroradiol 22:1480–1482PubMed

Briess D, Cotter D, Dosdi R et al (1998) Mammillary body abnormalities in schizophrenia. Lancet 352:789–790PubMedCrossRef

Butterworth RF, Gaudreau C, Vincelette J et al (1991) Thiamine deficiency and WE in AIDS. Metab Brain Dis 6:207–212PubMedCrossRef

Charness ME, DeLaPaz RL (1987) Mammillary bodies atrophy in Wernicke’s encephalopathy antemortem identification using magnetic resonance imaging. Ann Neurol 22:595–600PubMedCrossRef

Cirignotta F, Manconi M, Mondini S et al (2000) Wernicke-Korsakoff encephalopathy and polyneuropathy after gastroplasty formorbid obesity: report of a case. Arch Neurol 57:1356–1359PubMedCrossRef

D’ Aprile P, Gentile MA, Carella A (1994) Enhancement MR in the acute phase of WE. Am J Neuroradiol 15:591–593

Das A, Dhiman RK, Saraswat VA et al (2001) Prevalence and natural history of subclinical hepatic encephalopathy in cirrhosis. J Gastroenterol Hepatol 16:531–535PubMedCrossRef

Erlinger S, Benhamou J (1999) Cirrhosis: clinical aspects. In: Bircher J, Benhamou J, McIntyre N, Rizzeto M, Rode’s J (eds) Oxford Textbook of Clinical Hepatology. Oxford University, New York, pp 634–637

Fei GQ, Zhong C, Jin L et al (2008) Clinical characteristics and MR imaging features of nonalcoholic Wernicke encephalopathy. Am J Neuroradiol 29:164–169PubMedCrossRef

Frank O, Luisada-Opper A, Sorrell MF et al (1971) Vitamin deficits in severe alcohol fatty liver of man calculated from multiple reference points. Exp Mol Pathol 15:191–197PubMedCrossRef

Gallucci M, Bozzao A, Splendiani A et al (1990) Wernicke encephalopathy: MR finding in five patients. Am J Neuroradiol 11:887–892PubMed

Harper C (2006) Thiamine (vitamin B1) deficiency and associated brain damage is still common throughout the world and prevention is simple and safe!. Eur J Neurol 13:1078–1082PubMedCrossRef

Harper CG, Giles M, Finlay-Jones R (1986) Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry 49:341–345PubMedCrossRef

Hoyumpa AM (1980) Mechanisms of thiamine deficiency in chronic alcoholism. Am J Clin Nutr 33:2750–2761PubMed

Levy S, Herve C, Delacoux E et al (2002) Thiamine deficiency in hepatitis C virus and alcohol-related liver diseases. Dig Dis Sci 47:543–548PubMedCrossRef

Meldrum BS, Bruton DJ (1992) Epilepsy. In: Adams JH, Duchen LW (eds) Greenfield’s Neuropathology. Oxford University, New York, pp 1257–1259

Nath K, Saraswat VA, Krishna YR et al (2008) Quantification of cerebral edema on diffusion tensor imaging in acute-on-chronic liver failure. NMR Biomed 21:713–722PubMedCrossRef

Nautiyal A, Singh S, Alaimo DJ (2004) Wernicke encephalopathy: an emerging trend after bariatric surgery. Am J Med 117:804–805PubMedCrossRef

Shear PK, Sullivan EV, Lane B et al (1996) Mamillary body and cerebeller shrinkage in chronic alcoholics with and without amnesia. Alcohol Clin Exp Res 20:1469–1496CrossRef

Sheedy D, Lara A, Garrick T et al (1999) Size of mammillary bodies in health and disease: Useful measurement in neuroradiological diagnosis of Wernicke’s encephalopathy. Alcohol Clin Exp Res 23:1624–1628PubMed

Sullivan EV, Lane B, Deshmukh A et al (1999) In vivo mammillary body volume deficits in amnesic and nonamnesic alcoholics. Alcohol Clin Exp Res 23:1629–1636PubMed

Sziklas V, Petrides M (1998) Memory and the region of the mammillary bodies. Prog Neurobiol 54:55–70PubMedCrossRef

Tandon BN, Bernauau J, O’Grady J et al (1999) Recommendations of the International Association for the study of the Liver Subcommittee on nomenclature of acute and subacute liver failure. J Gastroenterol Hepatol 14:403–404PubMedCrossRef

Toth C, Voll C (2001) Wernicke’s encephalopathy following gastroplasty for morbid obesity. Can J Neurol Sci 28:89–92PubMed

Vann SD, Aggleton JP (2004) The mammillary bodies: two memory systems in one? Nat Rev Neurosci 1:35–44CrossRef

Victor, M. Ropper, A.H. (2001). Disease of the nervous system due to nutritional deficiency. In (Adams and Victor’s ed.), Principles of Neurology, McGraw-Hill Publishing Co, New York, pp.1205–1250

Zuccoli G, Gallucci M, Capellades J et al (2007) Wernike Encephalopathy: MR Finding at clinical presentation in twenty-six alcoholic and nonalcoholic patients. Am J Neuroradiol 28:1328–1331PubMedCrossRef

Title: Mammillary body atrophy in acute liver failure and acute-on-chronic liver failure of nonalcoholic etiology
Authors: Pranav Kumar Mandal
Santosh Kumar Yadav
Vivek Anand Saraswat
Jitesh Kumar Singh
Pooja Upreti
Rajendra Singh
Ram Kishore Singh Rathore
Rakesh Kumar Gupta
Publication date: 01-06-2009
Publisher: Springer US
Published in: Metabolic Brain Disease / Issue 2/2009
Print ISSN: 0885-7490
Electronic ISSN: 1573-7365
DOI: https://doi.org/10.1007/s11011-009-9140-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mammillary body atrophy in acute liver failure and acute-on-chronic liver failure of nonalcoholic etiology

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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