事象関連電位を用いた潜在性肝性脳症の評価に関する研究

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We applied event-related potential (ERP) (auditory P-300) for evaluation of subclinical hepatic encephalopathy in 33 liver cirrhotic patients without apparent encephalopathy. Both N-200 and P-300 latencies were significantly longer in the patient group than those in the control group. N-200 in decompensated cirrhotic patients was particularly delayed, significantly correlated with blood ammonia levels and the Fischer's ratio. Among several electrophysiological tests including EEG, appearance ratio of abnormal N-200 results was 45.5%, being the highest in the patient group. Hence, this approach seems particularly suitable for detecting subclinical encephalopathy. Multiple regression analysis revealed that abnormalities in ERP correlated primarily with positive past histories of ascites and/or hepatic encephalopathy, while drinking was not significantly concerned.<BR>We next used the Police Agency's driving fitness test (K-2) to evaluate the capacity for motor vehicle driving in patients with subclinical encephalopathy. The speed of movement in the group with delayed N-200 was significantly reduced as compared to that with normal N-200. Thus, N-200 latency may well be useful for evaluating the aptitude of motor vehicle driving in individuals with liver cirrhosis.