Recent Advances of Diagnosis and Treatment in Minimal Hepatic Encephalopathy of Cirrhotic Patients in Japan

Minimal hepatic encephalopathy (MHE) is a common cognitive disorder in cirrhotic patients, but is clinically asymptomatic. In Japan, It can be diagnosed by computer-based simple neuropsychiatric test with high specificity. Moreover, we recently established much more available and routine screening tool of MHE, using chronic liver disease questionnaire (CLDQ), from the viewpoint of less timeconsuming. Cirrhotic patients diagnosed as MHE can be medicated by several supplementations. L-carnitine is one of the treatment modalities of MHE. It would stimulate mitochondrial function, and reinforce the activity of the antioxidant enzymes, leading to the amelioration of MHE. Cases with MHE amelioration after the treatment had a significantly higher serum level of taurine before treatment, not only supporting pre-therapeutic prediction of MHE amelioration, but also being beneficial from a financial perspective.