Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2005; 11(43): 6792-6799
Published online Nov 21, 2005. doi: 10.3748/wjg.v11.i43.6792
Improvement of regional cerebral blood flow after oral intake of branched-chain amino acids in patients with cirrhosis
Mika Yamamoto, Motoh Iwasa, Kaname Matsumura, Yuri Nakagawa, Naoki Fujita, Yoshinao Kobayashi, Masahiko Kaito, Kan Takeda, Yukihiko Adachi
Mika Yamamoto, Motoh Iwasa, Naoki Fujita, Yoshinao Kobayashi, Masahiko Kaito, Yukihiko Adachi, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mie University School of Medicine, Tsu, Japan
Kaname Matsumura, Yuri Nakagawa, Kan Takeda, Department of Radiology, Mie University School of Medicine, Tsu, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Motoh Iwasa, MD, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mie University School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan. motoh@clin.medic.mie-u.ac.jp
Telephone: Fax: +81-59-231-5223
Received: February 17, 2005
Revised: June 1, 2005
Accepted: June 2, 2005
Published online: November 21, 2005
Abstract

AIM: To evaluate the effect of oral intake of branched-chain amino acids (BCAA) on brain perfusion in patients with liver cirrhosis.

METHODS: Single photon emission computed tomography scans were performed in 43 patients with cirrhosis and in 15 age-matched healthy subjects. Twenty-nine out of forty-three patients were randomly treated with either BCAA granules or placebo, and single photon emission computed tomography was performed before and after the treatment. We measured the regional cerebral blood flow values using a three-dimensional stereotaxic region of interest template.

RESULTS: Cirrhotic patients had regions of significant hypoperfusion in the bilateral central (right P = 0.039, P<0.05; left P = 0.006 P<0.01), parietal (right P = 0.018, P<0.05; left P = 0.009, P<0.01), angular (right P = 0.039, P<0.05; left P = 0.008, P<0.01), and left pericallosal segments (P = 0.038 P<0.05) as compared with healthy subjects. A significant increase in cerebral perfusion was observed 70 min after the oral intake of BCAA in the angular (right P = 0.012, P<0.05; left P = 0.049, P<0.05), temporal (right P = 0.012, P<0.05; left P=0.038, P<0.05), pericallosal segments (right P = 0.025, P<0.05; left P = 0.049, P<0.05) and left precentral (P = 0.044, P<0.05), parietal (P = 0.040, P<0.05) and thalamus (P = 0.033, P<0.05). No significant change in perfusion was observed in the placebo group.

CONCLUSION: Administration of BCAA rapidly improves cerebral perfusion.

Keywords: Liver cirrhosis; Cerebral blood flow; Branched-chain amino acids