FO nhibitory Control Test for the Diagnosis of Minimal Hepatic Encephalopathy

m m S n T ackground & Aims: Minimal hepatic encephalopahy (MHE) is difficult to diagnose. The Inhibitory ontrol Test (ICT) measures response inhibition and as diagnosed MHE with 90% sensitivity and specicity in a selected population; high lure and low arget rates indicated poor ICT performance. We tudied the reliability and validity of ICT for MHE iagnosis. Methods: ICT was compared with a psyhometric battery (standard psychometric tests SPT]) for MHE diagnosis and overt hepatic encephlopathy (OHE) prediction. ICT was administered wice for test-retest reliability, before/after transenous intrahepatic portosystemic shunting (TIPS), nd before/after yogurt treatment. The time taken by medical assistants (MA) to administer ICT was reorded and compared with that of a psychologist for ost analysis. Results: One hundred thirty-six cirhotic patients and 116 age/education-matched conrols were studied. ICT (>5 lures) had 88% sensitivity or MHE diagnosis with 0.902 area under the curve or receiver operating characteristic. MHE-positive atients had significantly higher ICT lures (11 vs 4, espectively, P .0001) and lower targets (92% vs 97%, espectively, P .0001) compared with MHE-negative atients. The test/retest reliability for ICT lures (n 0, r 0.90, P .0001) was high. ICT and SPT were quivalent in predicting OHE (21%). ICT lures signifcantly worsened after TIPS (n 10; 5 vs 9, respecively; P .02) and improved after yogurt supplemenation (n 18, 10 vs 5, respectively; P .002). The As were successfully trained to administer ICT; the ime required for test administration and the associted costs were smaller for ICT than for SPT. onclusions: ICT is a sensitive, reliable, and valid est for MHE diagnosis that can be administered nexpensively by MAs.