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Cognitive outcome in adults after bacterial meningitis
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  1. Martine Hoogman,
  2. Diederik van de Beek,
  3. Martijn Weisfelt,
  4. Jan de Gans,
  5. Ben Schmand
  1. Department of Neurology, Centre of Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, Amsterdam, the Netherlands
  1. Dr Diederik van de Beek, Department of Neurology, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands; d.vandebeek{at}amc.uva.nl

Abstract

Objective: To evaluate cognitive outcome in adult survivors of bacterial meningitis.

Methods: Data from three prospective multicentre studies were pooled and reanalysed, involving 155 adults surviving bacterial meningitis (79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls.

Results: Cognitive impairment was found in 32% of patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Survivors of pneumococcal meningitis performed worse on memory tasks (p<0.001) and tended to be cognitively slower than survivors of meningococcal meningitis (p = 0.08). We found a diffuse pattern of cognitive impairment in which cognitive speed played the most important role. Cognitive performance was not related to time since meningitis; however, there was a positive association between time since meningitis and self-reported physical impairment (p<0.01). The frequency of cognitive impairment and the numbers of abnormal test results for patients with and without adjunctive dexamethasone were similar.

Conclusions: Adult survivors of bacterial meningitis are at risk of cognitive impairment, which consists mainly of cognitive slowness. The loss of cognitive speed is stable over time after bacterial meningitis; however, there is a significant improvement in subjective physical impairment in the years after bacterial meningitis. The use of dexamethasone was not associated with cognitive impairment.

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Footnotes

  • Funding: This study was supported by a grant from the Meningitis Research Foundation, UK (DvdB grant No 03/03). The Dutch Meningitis Cohort was supported in part by an unrestricted research grant from Roche Pharmaceuticals (JdG). The European Dexamethasone Study was supported in part by a research grant from Organon NV (JdG). DvdB is supported by personal grants from the Netherlands Organisation for Health Research and Development (ZonMw) (NWO-Veni grant 2006 (916.76.023), NWO-Rubicon grant 2006 (019.2006.1.310.001)) and the Dr Jan Meerwaldt Foundation. MH, MW and BS have received no specific funding for this study.

  • Competing interests: None.

  • Abbreviations:
    EDS
    European Dexamethasone Study
    GIT
    Groningen Intelligence Test
    GOS
    Glasgow Outcome Scale
    POMS
    Profile of Mood States

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