A Pilot Study of a Screening Tool for Pediatric Minimal Hepatic Encephalopathy

Daniella Ohnemus, Katie Neighbors, Lisa G. Sorensen, Jin Shei Lai, Estella M. Alonso*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Despite the need for monitoring cognition for minimal hepatic encephalopathy (MHE) in children with portal hypertension, few screening methods exist. The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Perceived Cognitive Function (PedsPCF) item bank, a 43-item parent- and self-report questionnaire, could be a useful screening tool. This study aimed to evaluate the PedsPCF item bank as a screening tool and explore its correlation with other neurocognitive measures and clinical indicators of portal hypertension.Methods:Pediatric patients with portal hypertension were recruited at Lurie Children's Liver Clinic. A short battery of neuropsychological tests tapping attention, executive functioning, and fine motor speed was administered along with surveys of cognitive functioning (PedsPCF, Behavior Rating Inventory of Executive Function; BRIEF) and quality of life (PROMIS Pediatric-25 Profile).Results:Eighteen patients participated (ages 8 - 17). The PedsPCF correlated well with the BRIEF but did not correlate with neurocognitive testing. Qualitative heatmap analysis of the relationship between z-scores and clinical signs of portal hypertension suggests the PedsPCF is less sensitive than the BRIEF. The fine motor task (Grooved Pegboard) appears to offer the highest sensitivity of the tests administered and is also relatively quick and easy to administer.Conclusions:Elements of the battery show promise in this small pilot sample. The BRIEF and the Grooved Pegboard may hold the most potential for screening in the clinical setting. Further study is necessary to examine this question in a larger multicenter sample.

Original languageEnglish (US)
Pages (from-to)655-661
Number of pages7
JournalJournal of pediatric gastroenterology and nutrition
Volume69
Issue number6
DOIs
StatePublished - Dec 1 2019

Keywords

  • cognitive functioning
  • executive function
  • health-related quality of life
  • neuropsychological tests
  • portal hypertension

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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