Long-term Cognitive Outcomes in Tuberculous Meningitis.

Area of Science:

• Neurology
• Infectious Diseases
• Neuroimmunology

Background:

• Cognitive deficits are common in tuberculous meningitis (TBM) but not well-characterized.
• Understanding cognitive profiles and their correlation with inflammatory markers is crucial for TBM management.

Purpose of the Study:

• To investigate the cognitive profiles of patients with grade I TBM.
• To correlate cognitive impairment with cerebrospinal fluid (CSF) cytokine levels.

Main Methods:

• Prospective study of 60 grade I TBM patients.
• Collected clinical data, CSF cytokine levels (TNF-α, IFN-γ, IL-6), and performed neuropsychological assessments.
• Correlated cognitive test results with cytokine levels and assessed changes during follow-up.

Main Results:

• Significant elevation of TNF-α in definitive TBM cases.
• Widespread cognitive impairment observed, most notably in auditory verbal learning (88.3%), complex figure test (50%), and spatial span test (50%).
• Elevated IFN-γ and IL-6 levels correlated with the number of impaired neuropsychological tests; attention and working memory showed recovery, while verbal learning showed minimal improvement.

Conclusions:

• Subclinical cognitive impairment is evident in grade I TBM patients.
• Cognitive deficits correlate with elevated CSF cytokine levels, indicating an inflammatory component.
• Both frontal and temporal lobes are affected, with variable recovery patterns observed.