Minimal hepatic encephalopathy in hepatosplenic schistosomiasis: High prevalence and association with portosystemic shunts in a Brazilian cross-sectional study

Table 7 Comparative analysis of hepatic encephalopathy prevalence across different etiologies of non-cirrhotic portal hypertension

Ref.	Etiology	Country	Sample size	HE prevalence (%)	HE assessment method	Key findings related to PSS
Webb and Sherlock[26], 1979	EHPVO	United Kingdom	76	35.5	Clinical	High HE prevalence but no systematic PSS correlation
Sharma et al[28], 2008	EHPVO	India	22	31.82	Neuropsychological tests, CFF, blood ammonia, MRI	MHE correlates with PSS (72.7% vs 17.4%, P = 0.001)
Mohan and Venkataraman[27], 2011	EHPVO, INCPH	India	46	4.3	A and B track and CFF	No PSS correlation
Nicoletti et al[24], 2016	PVT and INCPH	Italy	51	PVT: 37.1; INCPH: 31.3	West Haven criteria, PHES, and the scan battery	Correlation with PSS in INCPH (71.4% vs 33.3%; P = 0.02)
Riggio et al[31], 2005	Cirrhosis	Italy	12	14	Neuropsychological tests, EEG, blood ammonia, MRI	Correlation with PSS (71% vs 14%; P = 0.002)
Present study	HSS	Brazil	200	24.5	Neuropsychological tests	Strong association between HE and PSS (P = 0.0018)

A and B track test: Attention and coordination tests used for minimal hepatic encephalopathy diagnosis; HE: Hepatic encephalopathy; PSS: Portosystemic shunts; EHPVO: Extrahepatic portal vein obstruction; INCPH: Idiopathic non-cirrhotic portal hypertension; PVT: Portal vein thrombosis; CFF: Critical flicker frequency; MRI: Magnetic resonance imaging; MHE: Minimal hepatic encephalopathy; PHES: Psychometric Hepatic Encephalopathy Score; EEG: Electroencephalogram.