Neurocognitive Outcome Following Tuberculous Meningitis Treatment in Adults: A Systematic Review

Abstract

Background Tuberculous meningitis (TBM) is an infectious diseases of the central nervous system that are still a global health challenge, including Indonesia. Patients who survive after experiencing TBM have a risk of functional, neurocognitive and psychological disorders that will affect daily activities. The aim of this study is to present a comprehensive review of data on neurocognitive outcome after TBM infection in adults.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 underwent duplicate screening by independent reviewers to assess eligibility for inclusion. Three independent reviewers extracted data from included studies.Result Among the article identified, 7 studies met our inclusion criteria, reporting on cognitive outcomes for 364 adults 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 comparing 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 in patients on TB therapy, there was improvement in cognitive function. Standardized reporting of neurocognitive outcomes will be essential to improve data quality and data-sharing potential.