▸ T1 hyperintensities in the globus pallidus and, less frequent, in the substantia nigra and the midbrain tegmentum

▸ FLAIR and DWI hyperintense thalami, posterior limbs of the internal capsule, periventricular region, dorsal brain stem and diffuse cortical involvement in 1 study of 20 patients

▸ In acute hepatic encephalopathy the widespread grey matter changes on FLAIR and DWI are often reversible, in contrast to anoxic-ischaemic encephalopathy

▸ Connectivity: decreased in the caudate of the anterior/middle cingulate gyrus; increased in the caudate of the left motor cortex; reduced between the putamen and the anterior cingulate gyrus, right insular lobe, inferior frontal gyrus, left parahippocampal gyrus and the anterior lobe of the right cerebellum; increased between the putamen and right middle temporal gyrus

▸ Increased glutamate/glutamine ratio and low myoinositol and choline on MRS

▸ Diminished choline and elevated glutamate/glutamine ratio in the parieto-occipital cortex on MRS

▸ High blood flow in the cerebellum, basal ganglia and cerebral cortex

▸ Alteration of striatal D2-receptor binding and dopamine reuptake

▸ Hypoperfusion of the superior and middle frontal gyri, and inferior parietal lobules

▸ Increased peripheral benzodiazepine binding sites prefrontal and striatal in patients with cirrhosis