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


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.


Hepatic Encephalopathy Cirrhotic Patient Minimal Hepatic Encephalopathy Wilcoxon Paired Test Beta Power 
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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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