Which of the branched-chain amino acids increases cerebral blood flow in hepatic encephalopathy? A double-blind randomized trial

Branched-chain amino acids increase the brain perfusion of patients with hepatic encephalopathy (HE), but the amino acid and the mechanisms involved are still unknown. This study compared brain perfusion and clinical improvement during leucine or isoleucine supplementation. After randomization, 27 s...

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Bibliographic Details
Published in:NeuroImage clinical 2018-01, Vol.19, p.302-310
Main Authors: Romeiro, Fernando Gomes, Ietsugu, Marjorie do Val, Franzoni, Letícia de Campos, Augusti, Laís, Alvarez, Matheus, Santos, Lívia Alves Amaral, Lima, Talles Bazeia, Koga, Kátia Hiromoto, Moriguchi, Sônia Marta, Caramori, Carlos Antonio, Silva, Giovanni Faria, Betting, Luiz Eduardo Gomes Garcia
Format: Article
Language:English
Subjects:
Aged
Brain - diagnostic imaging
Brain - drug effects
Brain - physiopathology
Branched-chain amino acids
Cerebral blood flow
Cerebrovascular Circulation - drug effects
Cerebrovascular Circulation - physiology
Double-Blind Method
Female
Hepatic encephalopathy
Hepatic Encephalopathy - diagnostic imaging
Hepatic Encephalopathy - physiopathology
Humans
Isoleucine - pharmacology
Leucine - pharmacology
Liver cirrhosis
Male
Middle Aged
Regular
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
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Summary:Branched-chain amino acids increase the brain perfusion of patients with hepatic encephalopathy (HE), but the amino acid and the mechanisms involved are still unknown. This study compared brain perfusion and clinical improvement during leucine or isoleucine supplementation. After randomization, 27 subjects with cirrhosis and HE received leucine or isoleucine supplements for one year. Brain single Photon Emission Computed Tomography (SPECT) and dynamic brain scintigraphy (DBS) were performed pretreatment and at 1, 8 and 12 months of supplementation. Brain perfusion was increased only in the isoleucine group at 8 months of treatment by both SPECT and DBS (p 
ISSN:2213-1582
2213-1582
DOI:10.1016/j.nicl.2018.03.028