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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2025; 31(36): 107703
Published online Sep 28, 2025. doi: 10.3748/wjg.v31.i36.107703
Published online Sep 28, 2025. doi: 10.3748/wjg.v31.i36.107703
Critical flicker frequency improves after alcohol detoxification and is associated with liver stiffness
Omar Elshaarawy, Shuai Lan, Johannes Mueller, Sebastian Mueller, Center for Alcohol Research, University of Heidelberg, Heidelberg 69120, Baden-Württemberg, Germany
Omar Elshaarawy, Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
Omar Elshaarawy, Department of Gastroenterology, Liverpool University, Liverpool L78XP, United Kingdom
Co-first authors: Omar Elshaarawy and Shuai Lan.
Author contributions: Elshaarawy O and Mueller J contributed to conceptualization; Lan S conducted the experiments; Mueller J performed the data analysis; Mueller S acquired funding and designed the study; Elshaarawy O and Lan S contributed equally as co-first authors. All authors contributed to writing-draft, writing-revision, and approved to submit the final version.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of University of Heidelberg, No. S150-2015.
Informed consent statement: All study participants, or their legal guardians, provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: There is no additional data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sebastian Mueller, PhD, Professor, Center for Alcohol Research, University of Heidelberg, In Neuenheimer Feld 350, Heidelberg 69120, Baden-Württemberg, Germany. sebastian.mueller@urz.uni-heidelberg.de
Received: April 7, 2025
Revised: May 18, 2025
Accepted: August 22, 2025
Published online: September 28, 2025
Processing time: 165 Days and 21.7 Hours
Revised: May 18, 2025
Accepted: August 22, 2025
Published online: September 28, 2025
Processing time: 165 Days and 21.7 Hours
Core Tip
Core Tip: This study demonstrates that critical flicker frequency (CFF), a non-invasive marker of neurocognitive function, significantly improves following alcohol detoxification in patients with alcohol-related liver disease (ALD). CFF was reduced in ALD patients and correlated with liver stiffness, particularly post-detoxification, highlighting its utility in detecting minimal hepatic encephalopathy. These findings underscore CFF’s value in assessing alcohol-related neurotoxicity and monitoring therapeutic response, supporting its integration into routine evaluation of patients with ALD and cirrhosis.