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Neuropsychological and psychiatric outcomes in encephalitis: A multi-centre case-control study
Lara Harris1, Julia Griem1, Alison Gummery2
1Institute of Psychiatry, Psychology and Neuroscience, King's College London (KCL), Camberwell, London, United Kingdom.
Plos One
|March 27, 2020
Summary
Herpes simplex virus encephalitis severely impacts memory and naming, while other causes affect memory moderately. Neuropsychological function improves, but subjective complaints like depression and anxiety persist post-encephalitis.
Area of Science:
- Neurology
- Neuropsychology
- Infectious Diseases
Background:
- Encephalitis, an inflammation of the brain, can result from various causes including Herpes simplex virus (HSV), other infections, autoimmune conditions, or remain of unknown origin.
- Understanding the long-term neuropsychological and psychiatric sequelae is crucial for patient recovery and rehabilitation.
Purpose of the Study:
- To compare neuropsychological and psychiatric outcomes in patients with encephalitis due to Herpes simplex virus (HSV), other causes, or unknown etiology.
- To assess the temporal evolution of these outcomes and their correlation with brain imaging findings.
Main Methods:
- Prospective study involving patients with encephalitis recruited from NHS hospitals.
- Neuropsychological and psychiatric assessments were conducted at short-term (4 months), medium-term (9-12 months), and long-term (>1 year) intervals post-discharge.
- Comparison with healthy control subjects and correlation with magnetic resonance imaging (MRI) findings.
Main Results:
- Herpes simplex virus (HSV) encephalitis patients exhibited severe deficits in anterograde and retrograde memory, alongside initial executive and naming impairments that resolved over time.
- Patients with other or unknown encephalitis causes showed moderate memory impairments but no significant executive deficits.
- Subjective cognitive complaints, tiredness, depression, and anxiety were prevalent, particularly in HSV and other encephalitis groups, persisting even after objective neuropsychological recovery.
Conclusions:
- Neuropsychological and psychiatric outcomes following encephalitis are dependent on the underlying etiology.
- Memory and naming deficits are most pronounced in HSV encephalitis, while other forms present with less severe memory impairments.
- While neuropsychological functioning generally improves, persistent subjective complaints and psychiatric issues necessitate targeted rehabilitation strategies.
