Neurocognitive and functional impairment in adult and paediatric tuberculous meningitis

Wellcome Open Research

article

Angharad G. Davis¹  Sam Nightingale⁴  Priscilla E. Springer⁵  Regan Solomons⁵  Ana Arenivas⁶  Robert J. Wilkinson²  Suzanne T. Anderson^1,10  Felicia C. Chow^1,12 

[1] University College London;Francis Crick Institute;Institute of Infectious Diseases and Molecular Medicine. Department of Medicine, University of Cape Town;HIV Mental Health Research Unit, University of Cape Town;Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University;The Institute for Rehabilitation and Research Memorial Hermann, Department of Rehabilitation Psychology and Neuropsychology;Baylor College of Medicine, Department of Physical Medicine and Rehabilitation;Department of Infectious Diseases, Imperial College London;Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine at Department of Medicine, University of Cape Town;MRC Clinical Trials Unit at UCL, University College London;Evelina Community;Weill Institute of Neurosciences, Department of Neurology and Division of Infectious Diseases, University of California

关键词: Tuberculous Meningitis;    Neurocognitive;    Functional;    Neurobehavioural;    Neurodevelopmental;    Psychiatric;   

DOI  :  10.12688/wellcomeopenres.15516.1

学科分类：内科医学

来源: Wellcome

【 摘 要 】

In those who survive tuberculous meningitis (TBM), the long-term outcome is uncertain; individuals may suffer neurocognitive, functional and psychiatric impairment, which may significantly affect their ability to lead their lives as they did prior to their diagnosis of TBM. In children who survive, severe illness has occurred at a crucial timepoint in their development, which can lead to behavioural and cognitive delay. The extent and nature of this impairment is poorly understood, particularly in adults. This is in part due to a lack of observational studies in this area but also inconsistent inclusion of outcome measures which can quantify these deficits in clinical studies. This leads to a paucity of appropriate rehabilitative therapies available for these individuals and their caregivers, as well as burden at a socioeconomic level. In this review, we discuss what is known about neurocognitive impairment in TBM, draw on lessons learnt from other neurological infections and discuss currently available and emerging tools to evaluate function and cognition and their value in TBM. We make recommendations on which measures should be used at what timepoints to assess for impairment, with a view to optimising and standardising assessment of neurocognitive and functional impairment in TBM research.

【 授权许可】

CC BY