Voxel-wise functional-to-gray matter volume ratios reveal distinct brain patterns in cirrhosis stratified by hepatic encephalopathy history and clinical status.

Authors

Zhen Yu, Minghui Mao, Qianghong Xue, Chengkun Hong, Hao Huang, Aling Shen, Liyuan Fu

Published in

Frontiers in neurology. Volume 17. Pages 1969935. Epub Oct 19, 2026.

Abstract

Hepatic encephalopathy (HE) is associated with distributed structural and functional brain abnormalities, but how local resting-state functional signals vary relative to gray matter volume (GMV) remains uncertain.
We retrospectively analyzed previously acquired magnetic resonance imaging (MRI) and clinical data from 97 participants after motion exclusion: 38 healthy controls (HCs), 29 patients with cirrhosis who had no history of overt HE and were classified as West Haven grade 0 at enrollment (NHE), and 30 patients in an operationally defined HE group. Voxel-wise regional homogeneity-to-GMV (ReHo-to-GMV) and amplitude of low-frequency fluctuation-to-GMV (ALFF-to-GMV) ratios were assessed in separate 3-group models adjusted for age, sex, education, and mean framewise displacement. Gaussian random-field cluster inference was used for the primary analysis, with 10,000-permutation threshold-free cluster enhancement (TFCE) as a non-parametric sensitivity analysis.
Corrected abnormalities were concentrated in HE versus HCs, whereas neither metric showed a corrected HE-versus-NHE difference. ReHo-to-GMV and ALFF-to-GMV each yielded 13 corrected clusters across the test-specific omnibus and directional results. Permutation and local-GMV-adjusted sensitivity analyses supported the principal HE-versus-HC effects. Cross-metric overlap was limited to 31 HCs > HE voxels (Dice = 0.0541), and none of the 48 exploratory region-of-interest clinical associations survived false-discovery-rate correction.
These ratios identify partly distinct group-level neuroimaging patterns of local functional signals relative to GMV in cirrhosis, but they should be interpreted as operational imaging measures rather than direct physiological coupling or validated biomarkers.

PMID:
42973542
Bibliographic data and abstract were imported from PubMed on 03 Nov 2026.

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