QSM and edited MRS reveal altered deep-brain gray matter microstructure and neurometabolism in patients with hepatic encephalopathy

Hepatic encephalopathy (HE) is a common neurological manifestation of liver cirrhosis characterized by altered brain microstructure and metabolism. Here, Quantitative Susceptibility Mapping (QSM) was performed in a well-characterized cohort of HE patients and correlated with metabolite estimates derived from GABA-edited MR spectroscopy. Deep-brain gray matter micro-susceptibility was significantly altered in the bilateral pallidum and dentate nuclei in HE patients. These results were closely linked to metabolite estimates and clinical metrics.