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Rifaximin reduces EEG relative beta power in patients with minimal hepatic encephalopathy: preliminary findings

  • F. Del Piccolo
  • P. Amodio
  • D. Mapelli
  • S. Montagnese
  • A. Pellegrini
  • P. Valenti
  • A. Ferrieri
  • A. Gatta

Abstract

Plasma benzodiazepine-like compounds (Bzd-L-Cs) are detectable in normal subjects, and their concentration increases in patients with progressive chronic liver disease. Bzd-L-Cs may precipitate hepatic encephalopathy (HE). The intestinal bacterial flora has been implicated in the production of Bzd-L-Cs and treatment with rifaximin may reduce their levels in patients with cirrhosis. Bzd-L-Cs increase EEG beta activity. We determined whether rifaximin treatment reduces EEG beta activity in patients with cirrhosis and minimal HE (mHE).

Eleven one-week courses of treatment, 8 rifaximin 600 to 1200 mg/day and 3 placebo, were randomly and blindly assigned to 5 cirrhotic patients with mHE (abnormal number connection test, symbol digit test or EEG).

After treatment, the relative beta power of the EEG decreased in the rifaximin-treated group (Wilcoxon paired test: Z = 2.1, p = 0.03), but not in the placebo-treated group (Z = 1.07, p NS). The EEG mean dominant frequency did not change. Psychometric tests did not change significantly; there was a trend for NCT to improve in the rifaximin-treated group (Wilcoxon paired test: Z = 1.7, p = 0.08).

In conclusion, the reduction of EEG beta activity in rifaximin-treated patients with mHE is compatible with previous observations that demonstrated a decrease in Bzd-L-C blood levels in patients with cirrhosis, who underwent rifaximin treatment.

Keywords

Hepatic Encephalopathy Cirrhotic Patient Minimal Hepatic Encephalopathy Wilcoxon Paired Test Beta Power 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media Dordrecht 2003

Authors and Affiliations

  • F. Del Piccolo
    • 1
  • P. Amodio
    • 1
  • D. Mapelli
    • 1
  • S. Montagnese
    • 1
  • A. Pellegrini
    • 1
  • P. Valenti
    • 1
  • A. Ferrieri
    • 2
  • A. Gatta
    • 1
  1. 1.department of Clinical and Experimental Medicine, Clinical Medicine 5University of PadovaPadovaItaly
  2. 2.Medical Services, Alpha WassermannBolognaItaly

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