Brain Structure Alterations in Patients With Hepatitis C Infection

Brain MRI
Brain MRI
Patients with chronic hepatitis C virus infection may experience structural alterations in the brain.

Patients with chronic hepatitis C virus (HCV) infection may experience structural alterations in the brain, according to results published in the Journal of NeuroVirology.

These changes include disturbances of cerebellothalamocortical regions and circuits.

The study included women with HCV and mild liver disease who were anti-HCV-antibody positive (n=19) and a group of healthy controls (n=16). All participants underwent extensive neuropsychological testing, voxel-based morphometry, and cranial magnetic resonance imaging examination.

After 6 to 7 years, the researchers followed up with 9 of the HCV-infected participants and 5 controls. They used voxel-based morphometry and magnetization transfer imaging to study HCV-associated structural gray and white matter changes.

Compared with controls, participants with HCV had significantly higher measures of fatigue and depression than control participants and performed worse on attention and memory tests.

At follow-up, researchers found that participants with HCV had gray matter atrophy in the bilateral insula and thalamus as well as atrophy in the left amygdala and left parahippocampal regions. Researchers also noted significant gray matter volume increases in the cerebellum. Using a reduced magnetization transfer ratio, the researchers also detected microstructural gray matter changes in the insula. They also observed white matter changes revealing a decrease in signal intensity along several descending and crossing fiber tracts, as well as through the anterior portion of the corpus callosum — compromise of the latter may contribute directly to a decline in cognitive function.

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“Our data provide evidence for the involvement of cerebellothalamocortical regions and circuits that link cerebellar projections to the prefrontal cortex through the thalamus in the development of neuropsychiatric symptoms in HCV-afflicted patients, thereby substantiating the role of these circuits in cognitive processing,” the researchers wrote.


Prell T, Dirks M, Arvanitis D, et al. Cerebral patterns of neuropsychological disturbances in hepatitis C patients [published online January 4, 2019]. J Neurovirol. doi:10.1007/s13365-018-0709-2