Publication Name	World Journal of Hepatology
Manuscript ID	118040
Country	India

Category	Gastroenterology & Hepatology
Manuscript Type	Prospective Study
Article Title	Differentiation of minimal and grade 1 hepatic encephalopathy using neurophysiological, neuropsychological, magnetic resonance spectroscopic, and systemic inflammatory parameters
Manuscript Source	Invited Manuscript
All Author List	Lalit C Kummetha, Shrey Bhatt, Venkatesh Vaithiyam, Barjesh C Sharma, Siddharth Srivastava, Bhawna Mahajan, Kalpana Bansal, Neera Chaudhry, Monica S Tandon, Sanjeev Sachdeva, Ajay Kumar, Ashok Dalal and Ujjwal Sonika
Funding Agency and Grant Number
Corresponding Author	Barjesh C Sharma, Director, DM, MD, Professor, Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, JLN Marg, Near Delhi Gate, New Delhi 110002, Delhi, India. drbcsharma@hotmail.com
Key Words	Hepatic encephalopathy; Neurospectroscopy; Bispectral index; Systemic inflammation; Endotoxins; Critical flicker frequency; Psychometric hepatic encephalopathy score; Serum ammonia
Core Tip	Minimal hepatic encephalopathy (MHE) and grade 1 hepatic encephalopathy (HE) are often collectively referred to as covert HE. In this prospective study, we compared neuropsychological, neurophysiological, inflammatory, and magnetic resonance spectroscopic parameters in cirrhotic patients with no HE, MHE, and grade 1 HE. Grade 1 HE exhibited significantly higher inflammatory markers, greater cerebral metabolic changes, and more severe Bispectral index and electroencephalography abnormalities than MHE. Grade 1 HE was independently associated with an increased risk of progression to overt HE, hospitalization, and death. These findings support that MHE and grade 1 HE are distinct entities.
Citation	Kummetha LC, Bhatt S, Vaithiyam V, Sharma BC, Srivastava S, Mahajan B, Bansal K, Chaudhry N, Tandon MS, Sachdeva S, Kumar A, Dalal A, Sonika U. Differentiation of minimal and grade 1 hepatic encephalopathy using neurophysiological, neuropsychological, magnetic resonance spectroscopic, and systemic inflammatory parameters. World J Hepatol 2026; In press

Received	2025-12-23 06:50
Peer-Review Started	2025-12-23 06:51
First Decision by Editorial Office Director	2026-01-12 09:03
Return for Revision	2026-01-12 09:03
Revised	2026-01-21 12:30
Publication Fee Transferred
Second Decision by Editor	2026-03-13 02:39
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-03-13 08:20
Articles in Press	2026-03-13 08:20
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
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