Assessment the Role of L-Carnitine in Improving Hepatic Encephalopathy Using MR Spectroscopy

Background and aim: Hepatic encephalopathy (HE) is related to abnormal cerebral metabolites. MR Spectroscopy (MRS) can demonstrate neurometabolites changes associated with therapy. The aim was to evaluate the influence of L-carnitine on mental Conditions, serum ammonia and neurometabolites on patients with HE using MRS. Patients and methods: Ten control subjects and 54 patients with grades II to III HE, were randomized into (GI) receiving lactulose 30ml/t.d.s as standard therapy and( GII) receiving L-Carnitine1000mg/twice in addition. Clinical assessment, fasting Ammonia level, and nuerometabolites using proton MRS were calculated and compared at base line and after one week. RESULTS: After one week, 25% of HE patients were reversed in group I versus 42.3% in group II. fasting ammonia levels were significantly decreased in both groups compared to pretreatment levels and significantly lower in L-carnitine group compared to lactulose group(P=0.041). neurometabolites mI/Cre, Cho/Cre, Gx/Cre, and (Cho+mI)/Gx ratios were significantly improved in both groups compared to pre treatment levels, but L Carnitine added group(II), showed a significant increase in mI/Cre, and (Cho+mI)/Glx ratios and decrease in Glx/Cre ratio in comparison to lactulose group(p=0.002-p=0.003-p=0.002 respectively). CONCLUSION: Adding L Carnitine to (lactulose) therapy for treatment HE hastened the clinical improvement and was associated with significant improvement in serum ammonia and neurometabolites specially mI/Cre, and (Cho+ mI)/Glx and Glx/Cre ratios . [Hanan H. Soliman, Dina H. Ziada, Mohamed Hefeda, Manal Hamisa and Samy A. Khodeir Assessment the Role of L-Carnitine in Improving Hepatic Encephalopathy Using MR Spectroscopy]J ournal of American Science 2012; 8(1): 715-721]. (ISSN: 1545-1003). http://www.americanscience.org. 97

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