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Cited by 155Bacterial Infections and VaccinesInfectious Encephalopathies and EncephalitisTraumatic Brain Injury Research

Neuropsychological sequelae of bacterial and viral meningitis

Schmidt, H., Heimann, B., Djukic, M., Mazurek, C., Fels, C., Wallesch, C.-W., Nau, R.·2006·Brain
DOI 10.1093/brain/awh711
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Abstract

Survivors of meningitis often complain about neurological and neuropsychological consequences. In this study, the extent of these sequelae was quantified and correlated to MRI findings. Neurological, neuropsychological and neuroradiological examinations were performed with adult patients younger than 70 years, 1-12 years after recovery from bacterial meningitis (BM; n = 59), or from viral meningitis (VM; n = 59). Patients with other potential causes for neuropsychological deficits (e.g. alcoholism) were carefully excluded. Patients were compared to 30 healthy subjects adjusted for age, gender and length of school education. With the exception of attention functions, both patient groups showed more frequently pathological results than the control group for all domains examined. Applying an overall cognitive sum score, patients after BM did not differ significantly in their performance from patients after VM. Separate analyses of various cognitive domains, however, revealed a higher rate of persistent disturbances in short-term and working memory after BM than after VM. Moreover, patients after BM exhibited greater impairment of executive functions. Associative learning of verbal material was also reduced. These deficits could not be ascribed to impaired alertness functions or decreased motivation in BM patients. Applying a logistic regression model, the neuropsychological outcome was related to the neurological outcome. Patients with a Glasgow Outcome Scale (GOS) of <5 had more frequently impaired test results for non-verbal learning and memory. GOS was also correlated with performance in executive functions. Brain volume was lower and ventricular volume was higher in the bacterial than in the VM group, and cerebral volume and the amount of white matter lesions of patients after BM were negatively correlated with short-term and working memory. In conclusion, patients after both BM and VM with favourable outcome showed affected learning and memory functions. More patients after BM than after VM displayed pathological short-term and working memory. BM resulted in poorer performance in executive functions, language, short-term memory and verbal learning/memory tests. As a result of neurological and neuropsychological sequelae, BM with a GOS > or = 4 led to decreased activities of daily living but only a minority of patients were disabled in a way that social functions were affected. The extent of neuropsychological sequelae of BM might have been overestimated in earlier studies which often had not been controlled for comorbidity factors such as alcoholism.

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Crossref · 10.1093/brain/awh711

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Authors
Schmidt, H., Heimann, B., Djukic, M., Mazurek, C., Fels, C., Wallesch, C.-W., & Nau, R.
Affiliations
University of Göttingen (DE)
Corresponding author
Schmidt, H.
ORCID
Venue
Brain
Publisher
Oxford University Press (OUP)
Published
2005-12-19
Volume
129
Issue
2
Pages
333-345
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
DOI
10.1093/brain/awh711
OpenAlex
W2063172274
Cited by
155
References
52
Citations by year
2026: 2 · 2025: 3 · 2024: 7 · 2023: 9 · 2022: 3 · 2021: 14 · 2020: 9 · 2019: 2 · 2018: 9 · 2017: 6 · 2016: 7 · 2015: 11 · 2014: 4 · 2013: 10 · 2012: 10
FWCI
5.83
Type
journal article
Language
en
Open access
closed
Locations
  • Brain (publishedVersion)
  • PubMed (publishedVersion)
  • GRO (submittedVersion)
Funders
Deutsche Forschungsgemeinschaft
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
bacterial meningitis, viral meningitis, post-infectious neurological sequelae, neuropsychological deficits, short-term memory, working memory, executive function, verbal learning and memory, white matter lesions, brain volume, ventriculomegaly, Glasgow Outcome Scale, activities of daily living
MeSH terms
Activities of Daily Living, Brain, Cognition Disorders, Depression, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Meningitis, Viral, Neuropsychological Tests, Regression Analysis, Case-Control Studies, Meningitis, Bacterial, Patient Selection

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