Modulation of GABAA receptors by neurosteroids. A new concept to improve cognitive and motor alterations in hepatic encephalopathy

J Steroid Biochem Mol Biol. 2016 Jun:160:88-93. doi: 10.1016/j.jsbmb.2015.08.020. Epub 2015 Aug 22.

Abstract

Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome affecting patients with liver diseases, mainly those with liver cirrhosis. The mildest form of HE is minimal HE (MHE), with mild cognitive impairment, attention deficit, psychomotor slowing and impaired visuo-motor and bimanual coordination. MHE may progress to clinical HE with worsening of the neurological alterations which may lead to reduced consciousness and, in the worse cases, may progress to coma and death. HE affects several million people in the world and is a serious health, social and economic problem. There are no specific treatments for the neurological alterations in HE. The mechanisms underlying the cognitive and motor alterations in HE are beginning to be clarified in animal models. These studies have allowed to design and test in animal models of HE new therapeutic approaches which have successfully restored cognitive and motor function in rats with HE. In this article we review the evidences showing that.

Keywords: Cognitive function; GABAA receptors; Hepatic encephalopathy; Hyperammonemia; Motor coordination; Neuroteroids.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain / drug effects*
  • Brain / metabolism
  • Brain / physiopathology
  • Cognition / drug effects*
  • Hepatic Encephalopathy / drug therapy*
  • Hepatic Encephalopathy / metabolism
  • Hepatic Encephalopathy / physiopathology
  • Humans
  • Hyperammonemia / drug therapy
  • Hyperammonemia / metabolism
  • Hyperammonemia / physiopathology
  • Locomotion / drug effects
  • Neurotransmitter Agents / metabolism
  • Neurotransmitter Agents / therapeutic use*
  • Psychomotor Performance / drug effects
  • Receptors, GABA-A / metabolism*

Substances

  • Neurotransmitter Agents
  • Receptors, GABA-A