Exploration of Digestive Diseases

Table 3. Neurological complications in hepatic failure.

Mechanism/Condition	Pathophysiological features	Neurological consequences
Ammonia accumulation [143]	Impaired detoxification leads to elevated ammonia, astrocyte glutamine overload, and oxidative stress.	Hepatic encephalopathy: confusion, lethargy, impaired cognition
Neuroinflammation [144]	Systemic cytokines sensitize the brain to ammonia; astrocyte dysfunction.	Exacerbated hepatic encephalopathy, impaired neuronal signaling
Altered neurotransmitter systems [145]	Increased GABAergic tone, reduced glutamatergic signaling, and monoamine imbalance.	Cognitive slowing, mood disturbances, psychomotor impairment
Wilson’s disease [146]	Copper accumulation in the liver and basal ganglia, a genetic defect in copper metabolism.	Tremor, dystonia, personality changes, cognitive decline
Mental health consequences [147]	Chronic inflammation and metabolic stressors affect the brain and behavior.	Depression, anxiety, and sleep disturbances

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Author contributions

AB: Conceptualization, Writing—original draft. SS: Conceptualization, Writing—original draft. KH: Writing—original draft. VR: Conceptualization, Writing—original draft, Writing—review & editing, Supervision. All authors read and approved the submitted version.

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The authors declare that there are no conflicts of interest.

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