scholarly journals Cognitive impairment in syphilis: Does treatment based on cerebrospinal fluid analysis improve outcome?

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254518
Author(s):  
Arielle P. Davis ◽  
Clare L. Maxwell ◽  
Haley Mendoza ◽  
Abby Crooks ◽  
Shelia B. Dunaway ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
High Risk ◽  
Cognitive Decline ◽  
Cognitively Impaired ◽  
Cognitive Complaints ◽  
Fluid Analysis ◽  
Csf Analysis ◽  
Persons Living With Hiv ◽  
Csf Pleocytosis

Background Individuals with previous syphilis may experience cognitive impairment. The goal of this study was to determine if those at high risk for laboratory-defined neurosyphilis are cognitively impaired, and whether treatment based on cerebrospinal fluid (CSF) findings results in better outcomes. Methods Participants had a new syphilis diagnosis, serum RPR titer ≥ 1:32 or peripheral blood CD4+ T cells ≤ 350/ul (in persons living with HIV) and did not endorse neurological symptoms. They underwent computerized cognitive assessment with the CogState. Thirty-two were randomized to either undergo lumbar puncture (LP) or to not undergo LP and 14 underwent LP; 64 were not randomized and 48 opted to undergo LP. Results Demographics, cognitive complaints and cognitive impairment did not differ between randomized and nonrandomized participants. Two-thirds were cognitively impaired, and impairment was not more common in those with cognitive complaints. The adjusted odds of increased severity of impairment were 3.8 times greater in those with CSF pleocytosis compared to those without. Time to cognitive normalization, improvement or decline did not differ between those who did not undergo LP and those who underwent LP and whose treatment was based on CSF analysis. Taking into account pre-treatment cognitive impairment, the risk of cognitive decline was lower in those with CSF pleocytosis treated for neurosyphilis compared to those without CSF pleocytosis not treated for neurosyphilis, (HR 0.24 (95% CI 0.07–0.88], p = 0.03). Conclusion In individuals at high risk for laboratory-defined neurosyphilis, cognitive complaints are not a good indicator of cognitive impairment. Severity of cognitive impairment was greater in those with CSF pleocytosis. Identification and treatment of those with neurosyphilis may mitigate subsequent cognitive decline.

scholarly journals Bacterial Meningitis in the Absence of Cerebrospinal Fluid Pleocytosis: A Case Report and Review of the Literature

2014 ◽  
Vol 25 (5) ◽  
pp. 249-251 ◽  
Author(s):  
Ryota Hase ◽  
Naoto Hosokawa ◽  
Makito Yaegashi ◽  
Kiyoharu Muranaka
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Lumbar Puncture ◽  
Early Stage ◽  
Review Of The Literature ◽  
Csf Analysis ◽  
Cell Counts ◽  
Csf Pleocytosis ◽  
Cerebrospinal Fluid Pleocytosis ◽  
Rule Out

Elevation of cerebrospinal fluid (CSF) cell count is a key sign in the diagnosis of bacterial meningitis. However, there have been reports of bacterial meningitis with no abnormalities in initial CSF testing. This type of presentation is extremely rare in adult patients. Here, a case involving an 83-year-old woman who was later diagnosed with bacterial meningitis caused byNeisseria meningitidisis described, in whom CSF at initial and second lumbar puncture did not show elevation of cell counts. Twenty-six non-neutropenic adult cases of bacterial meningitis in the absence of CSF pleocytosis were reviewed. The frequent causative organisms wereStreptococcus pneumoniaeandN meningitidis. Nineteen cases had bacteremia and seven died. The authors conclude that normal CSF at lumbar puncture at an early stage cannot rule out bacterial meningitis. Therefore, repeat CSF analysis should be considered, and antimicrobial therapy must be started immediately if there are any signs of sepsis or meningitis.

Increased Cerebrospinal Fluid Concentration of ZnT3 Is Associated with Cognitive Impairment in Alzheimer’s Disease

2020 ◽  
Vol 77 (3) ◽  
pp. 1143-1155
Author(s):  
Daniela Enache ◽  
Joana B. Pereira ◽  
Vesna Jelic ◽  
Bengt Winblad ◽  
Per Nilsson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Synaptic Proteins ◽  
Subjective Cognitive Decline

Background: Cognitive deficits arising in the course of Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), and Parkinson’s disease with dementia (PDD) are directly linked to synaptic loss. Postmortem studies suggest that zinc transporter protein 3 (ZnT3), AMPA glutamate receptor 3 (GluA3), and Dynamin1 are associated with cognitive decline in AD and Lewy body dementia patients. Objective: We aimed to evaluate the diagnostic value of ZnT3, GluA3, and Dynamin 1 in the cerebrospinal fluid (CSF) of patients with dementia due to AD, DLB, and PDD compared to cognitively normal subjective cognitive decline (SCD) patients in a retrospective study. In addition, we assessed the relationship between synaptic markers and age, sex, cognitive impairment, and depressive symptoms as well as CSF amyloid, phosphorylated tau (p-tau), and total tau (T-tau). Methods: Commercially available ELISA immunoassay was used to measure the levels of proteins in a total of 97 CSF samples from AD (N = 24), PDD (N = 18), DLB (N = 27), and SCD (N = 28) patients. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). Results: We found a significant increase in the concentrations of ZnT3, GluA3, and Dynamin1 in AD (p = 0.002) and of ZnT3 and Dynamin 1 in DLB (p = 0.001, p = 0.002) when compared to SCD patients. Changes in ZnT3 concentrations correlated with MMSE scores in AD (p = 0.011), and with depressive symptoms in SCD (p = 0.041). Conclusion: We found alteration of CSF levels of synaptic proteins in AD, PDD, and DLB. Our results reveal distinct changes in CSF concentrations of ZnT3 that could reflect cognitive impairment in AD with implications for future prognostic and diagnostic marker development.

Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q) – a research tool discriminating between subjectively cognitively impaired patients and healthy controls

2012 ◽  
Vol 25 (3) ◽  
pp. 420-430 ◽  
Author(s):  
Marie Eckerström ◽  
Johanna Skoogh ◽  
Sindre Rolstad ◽  
Mattias Göthlin ◽  
Gunnar Steineck ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Internal Consistency Reliability ◽  
Self Report ◽  
Cognitively Impaired ◽  
Healthy Controls ◽  
Memory Functioning ◽  
Α Level

ABSTRACTBackground: Subjective cognitive impairment (SCI) is a potential early marker for actual cognitive decline. The cognitive manifestation of the SCI stage is, however, largely unknown. Self-report instruments developed especially for use in the SCI population are lacking, and many SCI studies have not excluded mild cognitive impairment and dementia. We developed and tested a patient-based questionnaire on everyday cognitive function aiming to discriminate between patients with subjective, but not objective, cognitive impairment and healthy controls.Methods: Individuals experiencing cognitive impairment were interviewed to generate a pool of items. After condensing to 97 items, we tested the questionnaire in 93 SCI patients seeking care at a memory clinic (age M = 64.5 years, Mini-Mental State Examination (MMSE) M = 29.0) and 50 healthy controls (age M = 69.6 years, MMSE M = 29.3). Further item reduction was conducted to maximize that remaining items would discriminate between SCI patients and controls, using a conservative α level and requiring medium to high effect sizes. Internal consistency reliability and convergent validity was subsequently examined.Results: Forty-five items discriminated between the groups, resulting in the Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q). Internal consistency was high and correlations to a single question on memory functioning were of medium to large sizes. Most remaining items were related to the memory domain.Conclusion: The SASCI-Q discriminates between SCI patients and healthy controls and demonstrates satisfying psychometric properties. The instrument provides a research method for examining SCI and forms a foundation for future examining which SCI symptoms predict objective cognitive decline. The cognitive manifestation of the SCI stage is mostly related to experiences of memory deficits.

scholarly journals Role and Relevance of Cerebrospinal Fluid Cells in Diagnostics and Research: State-of-the-Art and Underutilized Opportunities

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 79
Author(s):  
Ferdinand Otto ◽  
Christine Harrer ◽  
Georg Pilz ◽  
Peter Wipfler ◽  
Andrea Harrer
Keyword(s):  
Cerebrospinal Fluid ◽  
State Of The Art ◽  
Csf Analysis ◽  
Immune Mediated ◽  
Csf Cells ◽  
Immune Phenotyping ◽  
Technical Issues ◽  
Csf Pleocytosis ◽  
Cns Immunity

Cerebrospinal fluid (CSF) has recently experienced a revival in diagnostics and research. However, little progress has been made regarding CSF cell analysis. For almost a century, CSF cell count and cytomorphological examination have been central diagnostic parameters, with CSF pleocytosis as a hallmark finding of neuroinflammation and cytology offering valuable clues regarding infectious, autoimmune, and malignant aetiologies. A great deal of information, however, remains unattended as modern immune phenotyping technologies have not yet been broadly incorporated into routine CSF analysis. This is a serious deficit considering the central role of CSF cells as effectors in central nervous system (CNS) immune defence and autoimmune CNS processes, and the diagnostic challenges posed by clinically overlapping infectious and immune-mediated CNS diseases. Here, we summarize historical, specimen-intrinsic, methodological, and technical issues determining the state-of-the-art diagnostics of CSF cells and outline future perspectives for this underutilized window into meningeal and CNS immunity.

scholarly journals COVID-19 - RELATED COGNITIVE IMPAIRMENT IN PATIENTS FOLLOWED AT A REFERRAL CENTER IN SÃO PAULO, BRAZIL

2021 ◽  
Author(s):  
Flávia Dahy ◽  
Aline Matos ◽  
Thais Romano ◽  
Rosa Maria Marcusso ◽  
Tatiane Assone ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Central Nervous System Involvement ◽  
P Value ◽  
Cognitive Complaints ◽  
Cognitively Normal ◽  
Normal Individuals ◽  
Cognitive Complaint ◽  
The Mean ◽  
Impaired Attention

Background: Central nervous system involvement associated with Coronavirus Disease 2019 (COVID-19) has been reported, including cognitive impairment, even in patients with mild COVID-19. processes. Objective: To assess cognitive decline related to the SARS-CoV-2 infection in patients with neurological disease after COVID-19. Methods: Longitudinal prospective study developed to compare the cognitive performance of patients after COVID-19 based on cognitive complaints. The Addenbrooke´s Cognitive ExaminationRevised (ACE-R), a 100-point test, was applied for investigation, with cut-off score for cognitively normal individuals ≥ 78. Results: Fifty patients were evaluated, 33 women (66%). Thirty-six patients with cognitive complaint (72%), this being the only symptom in 18 (50%), more frequent in women (5:1). Among all patients, the mean score of ACE-R was 80.8 (SD 11) and median of 84. In patients with cognitive complaints, mean of 80.37 (SD 12.2) and median of 84. For the other patients, mean of 81.86 (SD 7.65) and median of 82.5 (p value = 0.9869). Cognitive decline was confirmed in 10/35 (28.57%) of patients with cognitive complaint, and in 4/14 (28.57%) of other patients (exacto de Fisher = 0.8809). Regarding the ACE-R subanalyses, impaired attention and orientation were observed in both groups. Conclusion: Cognitive complaint was not a predictor of cognitive decline, but impairment in attention and orientation were observed in the entire sample.

scholarly journals Cerebrospinal fluid analysis in 58 ruminants showing neurological disorders

2020 ◽  
Vol 40 (5) ◽  
pp. 346-354
Author(s):  
Antônio Carlos L. Câmara ◽  
Mariana C. Gonzaga ◽  
Thaís M. Ziober ◽  
Cintia Regina R. Queiroz ◽  
Tayná C.M. Fino ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Neurological Disorders ◽  
Viral Infections ◽  
Experimental Studies ◽  
Clinical Signs ◽  
Pathological Findings ◽  
Cerebrospinal Fluid Analysis ◽  
Cns Diseases ◽  
Fluid Analysis ◽  
Csf Analysis

ABSTRACT: Ruminants may be affected by a wide variety of central nervous system (CNS) diseases. Cerebrospinal fluid (CSF) analysis forms the basis for ante mortem diagnostic evaluation of ruminants with clinical signs involving the CNS. Despite its importance as a tool to aid diagnosis, data regarding CSF examinations in spontaneous cases of CNS diseases in ruminants from Brazil are limited, and most reports involve experimental studies. Therefore, this study aimed to report the results of CSF analysis in 58 ruminants showing signs of neurological disorders. CSF samples for analysis were obtained from 32 cattle, 20 sheep, and 6 goats by cerebello-medullary cistern (n=54) or lumbosacral space (n=4) puncture. These ruminants showed neurological signs related to viral (n=13), mycotic (n=3), or bacterial (n=15) infections, and toxic (n=21), traumatic (n=4), or congenital disorders (n=2). CSF analysis from ruminants with viral infections presented lymphocytic pleocytosis, even though CSF showed no changes in several cases of rabies. Neutrophilic pleocytosis, cloudiness, presence of fibrin clots, and abnormal coloration were evident in the CSF of most cases of CNS bacterial infection, such as meningoencephalitis, meningitis, abscesses, myelitis, and a case of conidiobolomycosis. On the other hand, CSF was unchanged in most cases of toxic disorders, as botulism and hepatic encephalopathy. Elevated CSF density was observed in 60% of ruminants diagnosed with polioencephalomalacia. Our findings show that evaluation of CSF is a valuable diagnostic tool when used in association with epidemiological, clinical and pathological findings for diagnosis of CNS diseases in ruminants.

Subjective Memory Complaints and Conversion to Dementia in Patients with Subjective Cognitive Decline and Patients with Mild Cognitive Impairment

2016 ◽  
Vol 27 (2) ◽  
pp. 85-93 ◽  
Author(s):  
Johann Lehrner ◽  
Bettina Bodendorfer ◽  
Claus Lamm ◽  
Doris Moser ◽  
Peter Dal-Bianco ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Clinical Sample ◽  
Subjective Cognitive Decline ◽  
Memory Testing ◽  
Cognitive Complaints ◽  
Subjective Memory ◽  
Subjective Cognitive Complaints

Abstract. Background: Subjective cognitive complaints and their clinical significance are discussed controversially. Objectives: To determine the clinical validity of subjective cognitive complaints among subjects with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Design: Longitudinal study with one follow up examination at a University based out-patient memory clinic. Participants: A clinical sample of patietns with SCD and MCI (n = 141), aged 50 and older, who came to the memory outpatient clinic. Results: No significant differences between converters and non converters regarding subjective cognitive complaints were detected. MCI patients had a higher risk than the patients with SCD developing AD (OR = 7.3 [CI 0.9 to 61.2]. Verbal memory testing using the Verbal Selektive Reminding Test (VSRT) showed better diagnostic validity than subjective cognitive complaints using the Forgetfulness Assessment Inventory (FAI) in predicting conversion to dementia. Conclusion: Verbal memory testing was superior in predicting conversion to dementia compared to subjective cognitive complaints.

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