Source Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy CIRMANMEC, Inter-Departmental Centre for The Research and Modelling of Neuropsychiatric Disturbance in Internal Medicine, University of Padova, Padova, Italy Department of Neurophysiology, St Camillo Hospital, IRCCS, Venezia, Italy Liver Unit, Department of Medicine, St Mary's Hospital Campus, Imperial College London, London, UK.
Summary. Neuropsychological assessment has three main applications in clinical hepatology: (i) to detect, grade and monitor liver failure-related cognitive alterations in end-stage liver disease (hepatic encephalopathy), (ii) to substantiate complaints of attention or concentration difficulties in patients with non-cirrhotic chronic hepatitis C viral infection, and (iii) to screen patients who are being considered for liver transplantation for early signs of dementia. However, there is limited agreement on how cognitive assessment should be conducted in these patients, and how results should be interpreted and used to implement clinical decisions. In this review, we summarize the available literature on neuropsychological dysfunction in patients with cirrhosis and with chronic hepatitis C viral infection and provide some guidance on how to utilize neuropsychological assessment in practice.