Acetyl-L-carnitine Improves Cognitive Functions in Patients with Severe Hepatic Encephalopathy
Treatment with acetyl-L-carnitine (ALC) showed significant improvement in cognitive function for patients with severe hepatic encephalopathy. Sixty one patients with severe hepatic encephalopathy were recruited into this randomized, double-blind, placebo-controlled study. Subjects received either 2 g ALC twice a day or placebo 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 researchers 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 t ime -24.5 vs -2.4 (p < 0.001), NH (4) (+) 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 results suggest that ALC could represent a new tool in the treatment of severe hepatic encephalopathy.
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