Cognitive impairment and neuropsychiatric manifestations of neurobrucellosis

Aim This study aimed to reveal insight into the unclear areas of the diagnosis in neurobrucellosis and to decide the neuropsychiatric manifestations and cognitive impairment among patients with brucellosis. Methods 82 patients with serologically confirmed brucellosis were included and divided into two groups according to the neuropsychiatric manifestations, the first group included 18 patients with neurobrucellosis and the second group included 64 patients with non-neurobrucellosis. Both groups were compared regarding the general symptoms and neurological symptoms and signs. Cognitive impairment in both groups was assessed by Montreal-Cognitive Assessment (MoCA), Wechsler Memory Scale-Revised (WMS-R), and forward and backward digital test. Also, depression and anxiety were assessed by Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results 18 (21.9%) patients were diagnosed as neurobrucellosis and 64 (78.1%) patients were diagnosed as non-neurobrucellosis. The mean age of the total patients was 34.91 +/- 14.74, consisted of 45 males and 37. Most of the patients were living in rural areas 60 patients (74.4%). The most significantly higher neurological symptoms in neurobrucellosis patients were confusion and headache (P = 0.008 and P = 0.01, respectively). While the most significant higher neurological signs were loss of orientation (P = 0.009), muscle weakness (P = 0.04), neck rigidity (P < 0.05), pyramidal signs, and lost deep reflexes (P < 0.05). The neurobrucellosis patients had significantly impaired cognition in comparison with nonneurobrucellosis patients and more psychiatric signs like behavioral changes, anxiety, and depression (P < 0.001, P < 0.001, and P = 0.01, respectively). Conclusions Patients with neuropsychiatric manifestations and cognitive impairment should be considered for neurobrucellosis and should receive proper therapy.

Automated summary

Patients with neurobrucellosis exhibit cognitive impairment and more psychiatric symptoms, such as behavioral changes, anxiety, and depression, compared to those with non-neurobrucellosis. It is important to consider the diagnosis and treatment of neurobrucellosis in patients with neuropsychiatric manifestations.