EFFECTS OF LIVER CIRRHOSIS ON THE CENTRAL NERVOUS SYSTEM AND CLINICAL COMPLICATIONS

Abstract

Introduction: Liver cirrhosis is a chronic condition characterized by liver fibrosis, resulting in progressive damage that affects liver function. In addition to direct impacts on the liver, cirrhosis can have significant effects on the central nervous system (CNS), leading to a series of neurological and psychiatric complications. The accumulation of toxins due to impaired liver function can cause hepatic encephalopathy, while metabolic changes can affect cognition and behavior. These neurological effects are associated with serious clinical complications and can negatively impact the quality of life of patients. Objective: To examine the effects of liver cirrhosis on the central nervous system and the associated clinical complications, focusing on identifying the main mechanisms involved and evaluating management strategies. Methodology: The methodology followed the PRISMA checklist guidelines, including searching the PubMed, Scielo, and Web of Science databases. The descriptors used were “liver cirrhosis,” “central nervous system,” “hepatic encephalopathy,” “clinical complications,” and “cognitive function.” Articles published in the last 10 years that addressed the neurological effects of liver cirrhosis were included. Inclusion criteria were: original studies on liver cirrhosis and CNS, peer-reviewed articles, and publications within the last 10 years. Non-relevant studies, articles without direct evaluation of neurological effects, and publications older than 10 years were excluded. Results: The review revealed that liver cirrhosis can lead to several neurological complications, such as hepatic encephalopathy, characterized by changes in cognitive function and behavior. In addition, clinical complications such as hepatorenal syndrome and movement disorders were identified. Studies have shown that the accumulation of ammonia and other toxins due to liver dysfunction plays a crucial role in neurological deterioration. Conclusion: Liver cirrhosis exerts a significant impact on the central nervous system, with important consequences for patients' cognition and behavior. Associated clinical complications, such as hepatic encephalopathy, are frequent and substantially affect quality of life. Early identification and appropriate management of these complications are essential to improve clinical outcomes and quality of life of patients with liver cirrhosis.