Neurocognitive Outcome Following Tuberculous Meningitis Treatment : A Systematic Review

Muhammad Ilham Dhiya Rakasiwi; Erlina Burhan; Afid Brillana  Putra; Ihya Fakhrurizal  Amin; Nadhif Wiratara

doi:10.56310/pjns.v19i02.321

Muhammad Ilham Dhiya Rakasiwi Universitas Indonesia, Jakarta, Indonesia
Erlina Burhan Respiratory and Tuberculosis Research and Training Center (SATURATE), Jakarta, Indonesia https://orcid.org/0000-0002-8115-8293
Afid Brillana Putra Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-8985-5384
Ihya Fakhrurizal Amin Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-2024-9650
Nadhif Wiratara Universitas Indonesia, Jakarta, Indonesia

DOI: https://doi.org/10.56310/pjns.v19i02.321

Keywords: cognition, neurology, tuberculosis, prognosis, tuberculous meningitis

Abstract

Background and objective:

Tuberculous meningitis (TBM) is an infectious disease of the central nervous system that remains to be a global health challenge. Patients who survive after experiencing TBM have a risk of developing functional, cognitive and psychological disorders that can affect daily activities. The objective of this study is to present a comprehensive review of data on cognitive outcome after TBM infection.

Method:

We conducted a systematic literature search to identify studies addressing cognitive outcomes in adult TBM patients. Following a systematic literature search (PubMed, Scopus, EBSCO), studies were reviewed by independent reviewers to assess eligibility for inclusion. Three independent reviewers extracted data from included studies.

Result:

Among the articles identified, 6 studies met inclusion criteria, reporting cognitive outcomes for 330 patients with TBM. All studies followed the patients for 12 months or more. Three studies used Mini-Mental State Examinations (MMSE) to assess cognitive function, while other studies used a variety of tools: HIV-associated neurocognitive disorder (HAND), Montreal Cognitive Assessment (MoCA), neuropsychological (NEUROPSI), and Wechsler Adult Intelligence Scale (WAIS). All studies reported an improvement in cognitive function after completion of TB therapy. Two studies compared TBM with HIV, and showed TBM patients with HIV had worse cognitive outcomes than those without HIV.

Conclusion:

Cognitive function assessment tools in TBM patients are diverse and after approximately 12 months of follow-up following TB therapy, there was improvement in cognitive function. Standardized reporting of cognitive outcomes will be essential to improve data quality and data-sharing potential.