Preliminary research conducted by the applicants indicates that over 40% of nonalcoholic patients with chronic cholestatic liver disease demonstrate a clinically significant vitamin E deficiency. The severity of deficiency has additionally been found to covary with neurologic impairment and quantitative measures of psychomotor deficit. This study will further evaluate the extent to which vitamin E deficiency occurs in a variety of liver diseases and its relationship to the severity of liver injury. Furthermore, the proposed investigation also aims to evaluate the extent to which this vitamin deficiency can be ameliorated following a course of vitamin E supplementation. Concomitant to vitamin E treatment, recovery of neurologic function and psychomotor capacity will be monitored and measured. The findings obtained from this investigation will help clarify the multifactorial etiology of hepatic encephalopathy and improve the medical management of patients with chronic liver disease.
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