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OBJECTIVES:To compare inhibitory control test (ICT), a simple/rapid test of attention, toa standard psychometric battery (SPT) to diagnose minimal hepaticencephalopathy (MHE) and predict development of overt hepatic encephalopathy(OHE) in cirrhotic patients. METHODS: Fifty nonalcoholic cirrhotics and 50age/educational-status-matched controls were given ICT and SPT in the samesitting. Performance impaired beyond two standard deviations of controls wasconsidered MHE in cirrhotics. ICT results (lure/target response andlures/person) were compared between controls and cirrhotics and withincirrhotics with/without MHE. Receiver-operating characteristic analysis wasused to study ICT for MHE diagnosis. Twenty subjects were administered SPT andICT twice to assess test-retest reliability. All cirrhotics were followedroutinely for the development of OHE. RESULTS: Cirrhotics performed worse thancontrols on SPT and ICT. Using SPT, 39 cirrhotics had MHE. ICT was administeredfaster than SPT (15 vs 37 min). Cirrhotics with MHE had significantly higherlure (28%vs 3%) and lower target response (91%vs 96%) compared with thosewithout MHE. Lure/person >5 had 90% sensitivity/specificity for MHEdiagnosis. AUC for receiver-operating characteristic for lures alone was 95.8%.Lure and target responses were highly correlated (r= 0.9) between sessionsshowing high test-retest reliability. Five (10%) patients developed OHE on f/uof 26 +/- 10 months; all five had been diagnosed with MHE using ICT and SPT.None of the five patients with discordant results on SPT and ICT developed OHE.CONCLUSIONS: ICT has good sensitivity/specificity for MHE diagnosis, isreliable and is equivalent to SPT for predicting OHE developmentLeggil'articolo