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Neurocognitive Outcomes and Their Correlation with Brain-Based Biomarkers in Tuberculous Meningitis: A Prospective
Sanchit Shailendra Chouksey1, Varun Kumar Singh1, Rameshwar Nath Chaurasia1
1Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, India.
The American Journal of Tropical Medicine and Hygiene
|February 10, 2026
Summary
Tuberculous meningitis (TBM) commonly causes cognitive impairment, especially in attention and memory. While some biomarkers correlate with TBM severity, their link to cognitive recovery needs further study.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroimmunology
Background:
- Tuberculous meningitis (TBM) is a severe central nervous system infection with high mortality and neurological deficits.
- Cerebrospinal fluid (CSF) biomarkers are implicated in TBM's inflammatory response, but their association with cognitive outcomes remains unclear.
Purpose of the Study:
- To assess the cognitive profile in patients with early-stage TBM (grades 1 and 2).
- To investigate correlations between cognitive function and immunological/brain-based CSF biomarkers in TBM patients.
Main Methods:
- Sixty adult patients with definite/probable TBM (grades 1-2) were evaluated for cognition, neuroimaging, and CSF biomarkers (IFN-γ, IL-6, TNF-α, S100B, MMP-9, NSE) at baseline and 3-month follow-up.
- Cognitive function was assessed using the Indian Council of Medical Research Neurocognitive Toolbox Battery.
Main Results:
- Most TBM patients exhibited baseline cognitive impairment, particularly in attention, executive function, and memory.
- Partial cognitive recovery was observed at 3 months, more pronounced in grade 1 TBM.
- Elevated inflammatory (IL-6, IFN-γ, TNF-α) and brain biomarkers (S100B, NSE) were found in TBM patients compared to controls, but showed weak correlations with cognitive outcomes.
Conclusions:
- Neurocognitive impairment is prevalent in TBM, impacting various domains.
- Biomarkers may offer potential for monitoring TBM severity and recovery, though correlations with cognitive outcomes require further investigation.
- Larger, long-term studies are necessary to elucidate the precise role of these biomarkers in TBM neurocognitive outcomes.
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