Cognitive and everyday functioning after bacterial brain abscess: a prospective study of functional recovery from 8 weeks to 1 year post-treatment

Brain Inj. 2024 Aug 23;38(10):787-795. doi: 10.1080/02699052.2024.2347565. Epub 2024 Apr 27.

Abstract

Objective: A bacterial brain abscess may damage surrounding brain tissue by mass effect, inflammatory processes, and bacterial toxins. The aim of this study was to examine cognitive and functional outcomes at 8 weeks and 1 year following acute treatment.

Methods: Prospective study of 20 patients with bacterial brain abscess (aged 17-73 years; 45% females) with neuropsychological assessment at 8 weeks and 1 year post-treatment. Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and Patient Competence Rating Scale (PCRS) were used to assess everyday functioning and administered to patients and informants.

Results: Cognitive impairment was found in 30% of patients at 8 weeks and 22% at 1 year. Significant improvements were seen on tests of perceptual reasoning, attention, verbal fluency, and motor abilities (p < 0.05). At 1 year, 45% had returned to full-time employment. Nevertheless, patients and their informants obtained scores within the normal range on measures of everyday functioning (PCRS and BRIEF-A) at 8 weeks and 1 year. No significant improvements on these measures emerged over time.

Conclusion: Residual long-term cognitive impairment and diminished work ability affected 22% and 45% of patients one year after BA. Persistent cognitive impairment emphasizes the importance of prompt acute treatment and cognitive rehabilitation.

Keywords: Brain abscess; cognitive function; everyday function; neuropsychology; treatment.

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Aged
  • Brain Abscess* / psychology
  • Cognition / physiology
  • Cognition Disorders / etiology
  • Cognitive Dysfunction / etiology
  • Executive Function / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Prospective Studies
  • Recovery of Function* / physiology
  • Treatment Outcome
  • Young Adult