NAFLD ups risk of memory impairment, hippocampal damage

The presence and severity of nonalcoholic fatty liver disease (NAFLD) may contribute to cognitive impairment, as well as hippocampal structure and functional abnormalities, suggests a study.

Some 320 patients who underwent liver biopsy participated in this cross-sectional study. Of these, 225 underwent assessments of global cognition and cognitive subdomains, and 70 received functional magnetic resonance imaging (MRI) scans for neuroimaging evaluations.

Using structural equation model, the investigators explored the relationship among liver histological features, brain alterations, and cognitive functions.

Patients with NAFLD demonstrated poorer immediate memory and delayed memory compared with control participants. Severe liver steatosis (odds ratio [OR], 2.189; 95 percent confidence interval [CI], 1.020‒4.699) and ballooning (OR, 3.655; 95 percent CI, 1.419‒9.414) were associated with a higher proportion of memory impairment.

Structural MRI scans also revealed that patients with nonalcoholic steatohepatitis had volume loss in the left hippocampus and is subregions of subiculum and presubiculum. Likewise, task-based MRI showed a reduced left hippocampal activation in patients with nonalcoholic steatohepatitis.

In path analysis, the investigators found that NAFLD activity scores correlated with lower subiculum volume and decreased hippocampal activation. This hippocampal damage resulted in lower delayed memory scores.

“These findings stress the significance of early cognitive evaluation in patients with NAFLD,” the investigators said.