Cognitive Dysfunction in Non-Alcoholic Fatty Liver Disease-Current Knowledge, Mechanisms and Perspectives

Non-alcoholic fatty liver disease (NAFLD) has emerged as the hepatic component of the metabolic syndrome and now seemingly affects one-fourth of the world population. Features associated with NAFLD and the metabolic syndrome have frequently been linked to cognitive dysfunction, i.e. systemic inflamm...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-02, Vol.10 (4), p.673
Main Authors: Kjærgaard, Kristoffer, Mikkelsen, Anne Catrine Daugaard, Wernberg, Charlotte Wilhelmina, Grønkjær, Lea Ladegaard, Eriksen, Peter Lykke, Damholdt, Malene Flensborg, Mookerjee, Rajeshwar Prosad, Vilstrup, Hendrik, Lauridsen, Mette Munk, Thomsen, Karen Louise
Format: Article
Language:English
Subjects:
Alzheimer's disease
Body fat
Chemokines
Clinical medicine
Cognitive ability
Cytokines
Dementia
Inflammation
Insulin resistance
Intelligence tests
Liver diseases
Memory
Metabolic syndrome
Neuropsychology
Review
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Summary:Non-alcoholic fatty liver disease (NAFLD) has emerged as the hepatic component of the metabolic syndrome and now seemingly affects one-fourth of the world population. Features associated with NAFLD and the metabolic syndrome have frequently been linked to cognitive dysfunction, i.e. systemic inflammation, vascular dysfunction, and sleep apnoea. However, emerging evidence suggests that NAFLD may be a cause of cognitive dysfunction independent of these factors. NAFLD in addition exhibits dysbiosis of the gut microbiota and impaired urea cycle function, favouring systemic ammonia accumulation and further promotes systemic inflammation. Such disruption of the gut-liver-brain axis is essential in the pathogenesis of hepatic encephalopathy, the neuropsychiatric syndrome associated with progressive liver disease. Considering the growing burden of NAFLD, the morbidity from cognitive impairment is expected to have huge societal and economic impact. The present paper provides a review of the available evidence for cognitive dysfunction in NAFLD and outlines its possible mechanisms. Moreover, the clinical challenges of characterizing and diagnosing cognitive dysfunction in NAFLD are discussed.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10040673