Published online Nov 14, 2015. doi: 10.3748/wjg.v21.i42.11974
Peer-review started: June 6, 2015
First decision: August 31, 2015
Revised: September 11, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: November 14, 2015
Core tip: Neurocognitive dysfunction, sleep disturbance, depression, fatigue and reduced quality of life are common manifestations of chronic hepatitis C virus (HCV) infection. Neuropsychological performance is impaired in HCV patients, in the absence of structural brain alterations on conventional magnetic resonance imaging (MRI). Brain metabolic and microstructural changes are easily detected by in vivo proton magnetic resonance spectroscopy and perfusion-weighted/diffusion tensor MRI, enabling detection of brain dysfunction in clinically asymptomatic subjects. The regional distribution of metabolic changes indicates an exclusive involvement of telencephalic areas, but not the diencephalon or brainstem. HCV is likely to play a major pathogenic role in these disorders.