BACKGROUND/AIMS: The aim of the study was to correlate neuropsychological test results with regional cerebral biochemistry determined by magnetic resonance spectroscopy (MRS) in patients with minimal hepatic encephalopathy (MHE). METHODS: The patients with liver disease were divided into 4 groups; group 1 chronic hepatitis; group 2, liver cirrhosis (LC) without a history of HE; group 3, LC with a history of HE of no manifestation, and group 4, LC with overt HE. All patients were examined using neuropsychological tests and brain MRS. RESULTS: Trail making, Digit span, Digit symbol, and Peg board test in groups 2 and 3 were significantly different compared with control. These neuropsychological tests were regarded more available test for diagnosis of MHE. In the LC patients, compared with control, MRS results showed a typical pattern with decrease of myoinositol/Cr (0.24+/-0.24 vs. 0.68+/-0.10, p<0.05) and increased glutamine-glutamate/Cr (2.97+/-0.80 vs. 1.94+/-0.47, p<0.05). The difference of myoinositol/Cr and glutamine-glutamate/Cr between patients with MHE and control was statistically significant (0.16+/-0.15 vs. 0.68+/-0.10, 3.11+/-0.72 vs. 1.94+/-0.47, p<0.05). CONCLUSIONS: Neuropsychological tests and MRS maybe useful for diagnosing MHE.