Chronic liver disease can affect brain health

CRP may be a biomarker for cognitive decline in liver disease.

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Liver fibrosis, a progressive and potentially debilitating condition characterized by excessive accumulation of scar tissue in the liver, has long been recognized as a significant health concern. While its impact on liver function and overall physical health is well-documented, recent research has shed light on the potential effects of liver fibrosis on cognitive ability and brain structure. This emerging body of evidence suggests that liver fibrosis may be associated with reduced cognitive performance and alterations in brain volume, highlighting the need for further investigation into this intriguing link.

Understanding the relationship between liver fibrosis and brain health could lead to the development of targeted interventions and improved patient care. In this study, we aim to comprehensively explore the potential association between liver fibrosis, cognitive ability, and brain volume, providing valuable insights into the broader implications of this condition on neurological health.

Yale researchers have discovered a significant association between liver fibrosis, reduced cognitive ability, and decreased brain volume in specific brain regions. This connection is believed to be partially mediated by inflammation. The findings support the concept of a liver-brain axis and emphasize the importance of early monitoring of liver disease.

The study, conducted by Dustin Scheinost and his team, was recently published in biomedicine. This research adds to the mounting evidence demonstrating the interconnection between the brain and overall body health, highlighting the reciprocal impact of brain disorders and systemic diseases such as liver disease and heart disease.

Dustin Scheinost, associate professor of radiology and biomedical imaging at Yale University and senior author of the study, said, “More and more, folks are starting to realize that there’s not this split between brain-based disorders and other types of physical health. We’re starting to understand that liver disease, heart disease, and other diseases will impact the brain, and brain disorders impact the body.”

In a recent study utilizing data from the UK Biobank, researchers led by Dustin Scheinost investigated the potential impact of liver fibrosis on the brain. The study analyzed information from over half a million adults. It explored the association between liver fibrosis, cognitive function, and gray matter volume in various brain regions. The findings revealed that individuals with liver fibrosis exhibited reduced cognitive ability and decreased gray matter volume in key brain regions, including the hippocampus, thalamus, striatum, and brain stem, compared to healthy participants.

While the study couldn’t establish causality, it emphasized the importance of early surveillance and prevention of liver disease to mitigate cognitive decline and brain volume loss potentially. Furthermore, the researchers examined the potential role of inflammation, a common factor in liver and brain diseases, by using C-reactive protein as a marker of systemic inflammation, offering insights into the mediating factors of the observed liver fibrosis-brain connection.

The study revealed that participants with liver fibrosis had higher C-reactive protein levels, indicating systemic inflammation, than those without liver fibrosis. Furthermore, the researchers identified a significant mediating effect of C-reactive protein on the association between liver fibrosis, cognitive function, and brain volume. These findings suggest that inflammation contributes to the connection between the liver and the brain.

The study underscores the importance of early surveillance and prevention of liver disease, as early-stage liver fibrosis is potentially reversible, and addressing liver health may help reduce cognitive decline and brain volume loss. Targeting inflammation through interventions or medications could mitigate the disease burden of liver fibrosis.

Additionally, preventing liver disease may have implications for delaying the progression of neurodegenerative conditions such as dementia and Alzheimer’s disease. The study provides further evidence of the interconnection between physical, mental, and brain health, emphasizing the importance of addressing holistic well-being.

Journal Reference:

  1. Rongtao Jiang, Jing Wu et al. Elevated C-reactive protein mediates the liver-brain axis: a preliminary study. eBioMedicine. DOI: 10.1016/j.ebiom.2023.104679.