Rifaximin reduces EEG relative beta power in patients with minimal hepatic encephalopathy: preliminary findings
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.
KeywordsHepatic Encephalopathy Cirrhotic Patient Minimal Hepatic Encephalopathy Wilcoxon Paired Test Beta Power
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