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Distributed, limbic gray matter atrophy in patients after bacterial meningitis

N K Focke1, K Kallenberg, A Mohr

  • 1Department of Clinical Neurophysiology, University of Go¨ttingen, Robert-Koch-Str 40, Go¨ttingen, 37099, Germany. nfocke@uni-goettingen.de

AJNR. American Journal of Neuroradiology
|December 1, 2012
PubMed
Abstract

Insights

Bacterial meningitis (BM) survivors show significant gray matter loss in the brain, particularly the hippocampus, even with normal MRI scans. This atrophy correlates with cognitive deficits and may link BM to epilepsy.

Area of Science:

  • Neuroimaging
  • Neurology
  • Neuroscience

Background:

  • Cognitive deficits following bacterial meningitis (BM) in humans lack a clear structural basis.
  • Neuronal apoptosis in the hippocampal formation is implicated in animal models and autopsy studies.
  • In vivo analysis of BM's structural consequences using MRI is needed.

Purpose of the Study:

  • To investigate in vivo structural consequences of bacterial meningitis (BM) using MRI.
  • To assess morphologic differences in BM survivors with normal conventional MRI scans.

Main Methods:

  • Voxel-based morphometry (VBM) was applied to a cohort of BM survivors.
  • Conventional MRI scans were normal after acute inflammation resolution.
  • An atlas-based method corroborated VBM findings.

Main Results:

  • Significant gray matter volume loss was observed in the limbic system, including the hippocampal formation, thalamus, and cingulate gyri.
  • Temporal lobe gray matter also showed volume reduction.
  • Results were consistent between VBM and atlas-based analyses.

Conclusions:

  • Clear gray matter atrophy with a mesial temporal/limbic pattern is evident in BM survivors, even with normal routine MRI.
  • The observed atrophy pattern aligns with common neuropsychological deficits post-BM.
  • The findings suggest a potential causal link between BM and mesial temporal epilepsy.

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