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86 Combining lactulose with PEG might be helpful, which was assessed in a non-inferiority trial that randomized 40 patients with cirrhosis and HE to receive either lactulose alone (2030 g orally or 200 g enema) or a similar dose of lactulose plus PEG (280 g in 4 L of water orally as a single dose in 30120 m)

PL-PUFA, phospholipid containing polyunsaturated fatty acid chain

Any intervention that addresses these fundamental challenges holds promise for improving outcomes

Increased nuclear REST resulted directly decreasing the levels of miR-132 and miR-124a and indirectly via inhibition of BDNF expression consequently leading to inhibition of neurite outgrowth [69]