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Acetyl-L-carnitine improves cognitive functions in severe hepatic encephalopathy: a randomized and controlled clinical trial
Abstract
The aim of this study was to investigate the effects of ALC treatment on cognitive functions in patients with severe hepatic encephalopathy. This was a randomized, double-blind, placebo-controlled study. 61 patients with severe hepatic encephalopathy were recruited to the study. The 2 groups received either 2 g ALC twice a day (n = 30) or placebo (n = 30) for 90 days. Clinical and laboratory assessment, psychometric tests and automated electroencephalogram (EEG) analysis were performed for all patients. At the end of the study period, between the 2 groups we observed a significant difference in Everyday Memory Questionnaire -23.9 vs 4.4 (p < 0.001), Logical Memory (Paragraph recall) test 22.3 vs 0.7 (p < 0.001), Trail Making Test A -7.5 vs -2.6 (p < 0.001), Trail Making Test B -10.5 vs -3.1 (p < 0.001), Controlled Oral Word Association Test 4.2 vs 0.5 (p < 0.001), Hooper test 2.6 vs 0.1 (p < 0.05), Judgement of line orientation 2.8 vs 0.3 (p < 0.001), Digit Cancellation time -24.5 vs -2.4 (p < 0.001), NH₄⁺ 30.5 vs 13.5 (p < 0.001), prothrombin time 2 vs 2.4 (p < 0.05), alanine transaminase -10.7 vs -13.6 (p < 0.001). 88% of patients treated with ALC vs 72% of patients treated with placebo showed a significant improvement in EEG. The improvement of cognitive deficits, the reduction of ammonia, and the modification of EEG in patients treated with ALC suggest that ALC could represent a new tool in the treatment of severe hepatic encephalopathy.
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“ALC’s beneficial effects on cognition have been documented in the treatment of mild cognitive impairment and Alzheimer’s disease, as well as of hepatic encephalopathy [129, 130].”
From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [129]
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Metadata
- Authors
- Malaguarnera, M., Vacante, M., Motta, M., Giordano, M., Malaguarnera, G., Bella, R., Nunnari, G., Rampello, L., & Pennisi, G.
- Affiliations
- University of Catania (IT)
- Corresponding author
- Malaguarnera, Michele
- ORCID
- Venue
- Metabolic Brain Disease
- Published
- 2011-08-26
- Volume
- 26
- Issue
- 4
- Pages
- 281-289
- ISSN
- 0885-7490 (ISSN-L)
- 1573-7365
- OpenAlex
- W1990043320
- Cited by
- 61
- References
- 57
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 7 · 2019: 9 · 2018: 7 · 2017: 1 · 2016: 4 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 6
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Metabolic Brain Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Clinical Neurology › Alcoholism and Thiamine Deficiency
- Keywords
- acetyl-L-carnitine, hepatic encephalopathy, cognitive function, memory impairment, ammonia, EEG abnormalities, psychometric assessment, liver failure
- MeSH terms
- Acetylcarnitine, Adult, Alanine Transaminase, Ammonia, Bilirubin, Cognition, Double-Blind Method, Electroencephalography, Female, Hepatic Encephalopathy, Humans, Intelligence Tests, Male, Middle Aged, Prothrombin Time, Surveys and Questionnaires, Serum Albumin, Severity of Illness Index, Treatment Outcome, Nootropic Agents
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