Details

Autor(en) / Beteiligte

• Davis, Arielle P
• Maxwell, Clare L
• Mendoza, Haley
• Crooks, Abby
• Dunaway, Shelia B
• Storey, Sher
• Stevens, Claire
• Tantalo, Lauren C
• Sahi, Sharon K
• Robertson, Kevin R
• Marra, Christina M
• Muñoz-Moreno, Jose A.

Titel

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

Ist Teil von

• PloS one, 2021-07, Vol.16 (7), p.e0254518-e0254518

Ort / Verlag

San Francisco: Public Library of Science

Erscheinungsjahr

2021

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• 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. 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). 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.