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Thames AD, Castellon SA, Singer EJ, et al. Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C. Neurol Neuroimmunol Neuroinflamm. 2015;2(1):e59doi: 10.1212/NXI.0000000000000059.
Thames, A. D., Castellon, S. A., Singer, E. J., Nagarajan, R., Sarma, M. K., Smith, J., Thaler, N. S., Truong, J. H., Schonfeld, D., Thomas, M. A., & Hinkin, C. H. (2015). Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C. Neurology(R) neuroimmunology & neuroinflammation, 2(1), e59. https://doi.org/10.1212/NXI.0000000000000059
Thames, April D, et al. "Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C." Neurology(R) neuroimmunology & neuroinflammation vol. 2,1 (2015): e59. doi: https://doi.org/10.1212/NXI.0000000000000059
Thames AD, Castellon SA, Singer EJ, Nagarajan R, Sarma MK, Smith J, Thaler NS, Truong JH, Schonfeld D, Thomas MA, Hinkin CH. Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C. Neurol Neuroimmunol Neuroinflamm. 2015 Jan 14;2(1):e59. doi: 10.1212/NXI.0000000000000059. eCollection 2015 Feb. PMID: 25610883; PMCID: PMC4299885.
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Neurol Neuroimmunol Neuroinflamm. 2015 Jan 14;2(1):e59. doi: 10.1212/NXI.0000000000000059. eCollection 2015 Feb.

Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C.

Neurology(R) neuroimmunology & neuroinflammation

April D Thames, Steven A Castellon, Elyse J Singer, Rajakumar Nagarajan, Manoj K Sarma, Jason Smith, Nicholas S Thaler, Jonathan Hien Truong, Daniel Schonfeld, M Albert Thomas, Charles H Hinkin

Affiliations

  1. David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA.

PMID: 25610883 PMCID: PMC4299885 DOI: 10.1212/NXI.0000000000000059

Abstract

OBJECTIVE: This study examined neurologic abnormalities (as measured by proton magnetic resonance spectroscopy imaging and diffusion tensor imaging), neurocognitive performance, and fatigue among a sample of adults with hepatitis C virus (HCV). We hypothesized that HCV+ individuals would demonstrate structural brain abnormalities and neurocognitive compromise consistent with frontostriatal dysfunction as well as increased fatigue compared to controls.

METHOD: Participants were 76 individuals diagnosed with HCV and 20 controls who underwent a comprehensive neurocognitive evaluation and clinical assessments. A subset of the HCV+ participants (n = 29) and all controls underwent MRI.

RESULTS: Individuals diagnosed with chronic HCV infection demonstrated greater fractional anisotropy in the striatum as well as greater mean diffusivity in the fronto-occiptal fasciculus and external capsule compared to HCV- controls. HCV+ participants also demonstrated lower levels of N-acetylaspartate in bilateral parietal white matter and elevations in myo-inosital (mI) in bilateral frontal white matter compared to HCV- controls (all p values < 0.05). HCV+ participants also demonstrated significantly poorer neuropsychological performance, particularly in processing speed and verbal fluency. HCV+ patients reported higher levels of fatigue than controls, and fatigue was significantly correlated with diffusivity in the superior fronto-occipital fasciculus, elevations in mI in frontal white matter, and overall cognitive performance.

CONCLUSIONS: Our results suggest that HCV-associated neurologic complications disrupt frontostriatal structures, which may result in increased fatigue and poorer cognitive performance, particularly in those cognitive domains regulated by frontostriatal regions.

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