HIV-Negative Cryptococcal Meningoencephalitis Results in a Persistent Frontal-Subcortical Syndrome

Twenty-seven previously healthy (of 36 consecutive eligible patients), HIV-negative cryptococcal meningoencephalitis (CM) patients underwent comprehensive neuropsychological evaluation during the late post-treatment period (1.3-4 years post diagnosis), assessing attention, language, learning, memory...

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Bibliographic Details
Published in:Scientific reports 2019-12, Vol.9 (1), p.18442-9, Article 18442
Main Authors: Traino, Katherine, Snow, Joseph, Ham, Lillian, Summers, Angela, Segalà, Laura, Shirazi, Talia, Biassou, Nadia, Panackal, Anil, Anjum, Seher, Marr, Kieren A, Kreisl, William C, Bennett, John E, Williamson, Peter R
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alzheimer Disease - complications
Alzheimer Disease - physiopathology
Antifungal Agents - therapeutic use
Cognition Disorders - diagnosis
Cognition Disorders - etiology
Cognition Disorders - physiopathology
Cognitive ability
Cryptococcus neoformans - isolation & purification
Datasets as Topic
Dementia disorders
Encephalitis
Executive function
Executive Function - physiology
Female
Frontal Lobe - diagnostic imaging
Frontal Lobe - physiopathology
Gliosis - diagnosis
Gliosis - microbiology
Gliosis - physiopathology
HIV
HIV-1 - isolation & purification
Human immunodeficiency virus
Humans
Hydrocephalus - diagnosis
Hydrocephalus - microbiology
Hydrocephalus - physiopathology
Information processing
Learning
Magnetic Resonance Imaging
Male
Memory
Meningitis
Meningitis, Cryptococcal - complications
Meningitis, Cryptococcal - drug therapy
Meningitis, Cryptococcal - microbiology
Meningitis, Cryptococcal - physiopathology
Meningoencephalitis
Meningoencephalitis - complications
Meningoencephalitis - drug therapy
Meningoencephalitis - microbiology
Meningoencephalitis - physiopathology
Middle Aged
Mood
Neuropsychological Tests - statistics & numerical data
Spatial memory
Syndrome
Young Adult
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Description
Summary:Twenty-seven previously healthy (of 36 consecutive eligible patients), HIV-negative cryptococcal meningoencephalitis (CM) patients underwent comprehensive neuropsychological evaluation during the late post-treatment period (1.3-4 years post diagnosis), assessing attention, language, learning, memory, visuospatial, executive function, information processing, psychomotor functioning, as well as mood symptoms. Seven of eight domains (all except attention) showed increased percentages of CM patients scoring in the less than 16 percentile range compared to standardized normative test averages, adjusted for education level and age. Comparison with a matched archival dataset of mild cognitive impairment/Alzheimer's disease patients showed that CM patients exhibited relative deficits in psychomotor and executive function with fewer deficits in memory and learning, consistent with a frontal-subcortical syndrome. MRI evaluation at the time of testing demonstrated an association of lower neuropsychological functioning with ventriculomegaly. These studies suggest that CM should be included in the list of treatable causes of dementia in neurological work ups. Future studies are needed to identify diagnostic and treatment regimens that may enhance neurological function after therapy.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-019-54876-7