Cognitive Impairment
Studies suggest that liver illnesses associated with NAFLD are strongly linked to various problems in the Central Nervous System. Mood abnormalities, cognitive impairment, and episodic memory impairment are CNS dysfunctions associated with NAFLD. Hepatic encephalopathy or portosystemic encephalopathy (PSE) is one of the neuropsychiatric problems caused by NAFLD.
A healthy liver processes ammonia and the waste is excreted in the urine, but a dysfunctional liver can cause ammonia buildup. The neurotoxins that induce PSE are carried to the brain when vein blood is diverted into the systemic circulation without being processed by the liver.
PSE’s cognitive and neuromuscular symptoms emerge gradually and proceed through various clinical phases. The effects are minimal in the first grade of PSE, leading to disruptions in the circadian rhythm. Fatigue and mood problems can occur in the second grade. Patients in grade 3 may have nonsensical speech, extreme drowsiness, and even convulsions. Patients with grade 4 hepatic encephalopathy, the most severe kind, can lead to a coma and unresponsiveness.
Moreover, there is a link between NAFLD and the emergence of depressive and anxious symptoms. However, some of the symptoms of portosystemic encephalopathy may be reversed by restoring normal liver function, for instance, by a liver donation.
