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Cognitive impairment in tuberculous meningitis: Systematic review & meta-analysis
J V Ashwin1, Rajesh Verma2, Mohit Kumar Shahi1
1Department of Geriatric Mental Health, King George Medical University, Lucknow, India.
The Indian Journal of Tuberculosis
|March 14, 2026
Summary
Tuberculous meningitis (TBM) survivors experience significant cognitive decline, particularly in executive function and memory. While some recovery occurs, long-term deficits necessitate standardized assessments and targeted interventions for improved TBM management.
Area of Science:
- Neuroscience
- Infectious Diseases
- Public Health
Background:
- Tuberculous meningitis (TBM) is a severe CNS form of tuberculosis.
- TBM survivors often face long-term cognitive impairment, impacting quality of life.
- Understanding TBM-related cognitive deficits is crucial for effective treatment and rehabilitation.
Purpose of the Study:
- To systematically review and meta-analyze cognitive dysfunction in TBM survivors.
- To identify affected cognitive domains and assess the long-term impact of impairment.
- To provide recommendations for standardized assessment timing and tools in TBM.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched PubMed, Scopus, Web of Science, Embase, Google Scholar, and CINAHL for relevant studies.
- Included seven studies with cognitive function assessments at various TBM treatment stages; meta-analysis used a random-effects model.
Main Results:
- Meta-analysis revealed significant cognitive decline in TBM individuals compared to controls (cognitive score reduction of 11.72).
- Subgroup analysis indicated partial cognitive recovery over time, but persistent deficits in executive function and verbal memory.
- High heterogeneity observed due to variations in cognitive assessment tools.
Conclusions:
- Long-term cognitive deficits persist in TBM survivors despite some recovery.
- Standardized cognitive assessment protocols and targeted interventions are essential for TBM management.
- Recommends periodic assessments using tools like ACE-III and TMT-A & B, and uniform future research methodologies.
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