Table 2.

Studies on liver damage-related Mn toxicity due to compromised Mn excretion

References	Findings
Brunberg et al., 1991 (34)	MRI T1 hyperintensity in globus pallidus observed in 30 of 42 patients with chronic liver failure.
Hauser et al., 1996 (29)	Correlation between blood Mn levels and MRI T1-hyperintensity scores observed in patients with chronic hepatic cirrhosis.
Pomier-Layrargues et al., 1995 (27)	2- to 7-fold higher pallidal Mn detected in the autopsies of patients who died from cirrhosis-related complications.
Spahr et al., 1996 (28)	88% of patients with cirrhosis exhibit pallidal T1 hyperintensity. In addition, shows association between blood Mn levels and T1 pallidal MRI intensity.
Maeda et al., 1997 (35)	Increased Mn levels were observed in the pallidus, caudate, putamen, and cortex in autopsy samples from patients with cirrhosis.
Rose et al., 1999 (30)	Rats with biliary cirrhosis or portacaval shunt present increased Mn levels in pallidum and caudate.
Spahr et al. 2000 (32)	MRI T1 hyperintensity of patients with hepatic encephalopathy correlates with severity of parkinsonian signs. 3 patients showed disappearance of T1 hyperintensity and improvement in parkinsonian signs after liver transplant.
Burkhard et al. 2003 (33)	Blood Mn levels of all examined patients with cirrhosis are higher than normal values and comparable with those of patients with occupational Mn toxicity.
Long et al. 2009 (31)	Observed correlation between Mn levels in globus pallidus and chronic liver disease severity. Patients with cirrhosis who receive liver transplants have normalized brain Mn levels 3 mo posttransplant.

Mn, manganese.