Abstract: Objective To investigate the changes of brain functional connectivity of bilateral precuneus and other brain regions in patients with minimal hepatic encephalopathy based on resting-state fMRI. Methods 95 patients with hepatic encephalopathy (observation group) and 95 cases of physical examinees (control group) in our hospital from May 2016 to March 2019 were selected. All the selected subjects underwent fMRI. The changes of functional connectivity of bilateral precuneus and other brain regions were observed. The blood ammonia level, number connection test (NCT) and digit symbol test (DS) results were observed, and their correlation with disrupted functional connectivity was determined by spearman correlation analysis. Results The blood ammonia level and digital connection test results of the observation group were higher than those of the control group, and the digit symbol test results were lower than the control group (P<0.05). The brain functional connectivity of left precuneus with left inferior parietal lobule, right superior frontal gyrus, left insula, and left middle cingulate gyrus in the observation group was lower than those of the control group, while the brain functional connectivity of left precuneus with left superior frontal gyrus was higher than that of the control group (P<0.05). The brain functional connectivity of right precuneus with right supramarginal gyrus, right temporal pole, bilateral frontal lobe, medial cingulum cortex and left superior temporal gyrus in the observation group was lower than those of the control group, while the brain functional connectivity of right precuneus with left posterior cingulate gyrus was higher than that of the control group (P<0.05). Conclusion Abnormal resting-state functional connectivity of bilateral precuneus and multiple brain regions are demonstrated in patients with minimal hepatic encephalopathy, which may be the mechanism of endogenous neurological impairment of minimal hepatic encephalopathy.

Key words: Resting-state fMRI, Hepatic encephalopathy, Bilateral precuneus, Functional connectivity