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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Neuropsychological and psychiatric outcomes in encephalitis
T2 - A multi-centre case-control study
AU - ENCEPH UK study group
AU - Harris, Lara
AU - Griem, Julia
AU - Gummery, Alison
AU - Marsh, Laura
AU - Defres, Sylviane
AU - Bhojak, Maneesh
AU - Das, Kumar
AU - Easton, Ava
AU - Solomon, Tom
AU - Kopelman, Michael
AU - Barlow, Gavin
AU - Beeching, Nick
AU - Blanchard, Thomas
AU - Body, Richard
AU - Boyd, Gavin
AU - Cebria-Prejan, Lucia
AU - Chadwick, David
AU - Cooke, Richard
AU - Crawford, Pamela
AU - Davies, Brendan
AU - Davies, Nick
AU - Douthwaite, Sam
AU - Emsley, Hedley
AU - Goldenberg, Simon
AU - Graham, Clive
AU - Green, Steve
AU - Hawkins, Clive
AU - Irish, Dianne
AU - Jeffrey, Kate
AU - Jones, Matt
AU - Keating, Liza
AU - Keep, Jeff
AU - Kopelman, Michael
AU - Larkin, Susan
AU - Leita, Maria
AU - Macallan, Derek
AU - Minton, Jane
AU - Mohandas, Kavya
AU - Moran, Ed
AU - Muir, David
AU - Pasztor, Monicka
AU - Reed, Matthew
AU - Solomon, Tom
AU - Stanley, Philip
AU - Sutton, Julian
AU - Thomas, Peter
AU - Weir, John
AU - Brown, David
AU - Tharmaratnam, Kukatharmini
AU - Thornton, Maria
PY - 2020/3/25
Y1 - 2020/3/25
N2 - Objectives Our aim was to compare neuropsychological and psychiatric outcomes across three encephalitis aetiological groups: Herpes simplex virus (HSV), other infections or autoimmune causes (Other), and encephalitis of unknown cause (Unknown). Methods Patients recruited from NHS hospitals underwent neuropsychological and psychiatric assessment in the short-term (4 months post-discharge), medium-term (9-12 months after the first assessment), and long-term (>1-year). Healthy control subjects were recruited from the general population and completed the same assessments. Results Patients with HSV were most severely impaired on anterograde and retrograde memory tasks. In the short-term, they also showed executive, IQ, and naming deficits, which resolved in the long-term. Patients with Other or Unknown causes of encephalitis showed moderate memory impairments, but no significant impairment on executive tests. Memory impairment was associated with hippocampal/medial temporal damage on magnetic resonance imaging (MRI), and naming impairment with left temporal and left frontal abnormalities. Patients reported more subjective cognitive complaints than healthy controls, with tiredness a significant problem, and there were high rates of depression and anxiety in the HSV and the Other encephalitis groups. These subjective, self-reported complaints, depression, and anxiety persisted even after objectively measured neuropsychological performance had improved. Conclusions Neuropsychological and psychiatric outcomes after encephalitis vary according to aetiology. Memory and naming are severely affected in HSV, and less so in other forms. Neuropsychological functioning improves over time, particularly in those with more severe short-term impairments, but subjective cognitive complaints, depression, and anxiety persist, and should be addressed in rehabilitation programmes.
AB - Objectives Our aim was to compare neuropsychological and psychiatric outcomes across three encephalitis aetiological groups: Herpes simplex virus (HSV), other infections or autoimmune causes (Other), and encephalitis of unknown cause (Unknown). Methods Patients recruited from NHS hospitals underwent neuropsychological and psychiatric assessment in the short-term (4 months post-discharge), medium-term (9-12 months after the first assessment), and long-term (>1-year). Healthy control subjects were recruited from the general population and completed the same assessments. Results Patients with HSV were most severely impaired on anterograde and retrograde memory tasks. In the short-term, they also showed executive, IQ, and naming deficits, which resolved in the long-term. Patients with Other or Unknown causes of encephalitis showed moderate memory impairments, but no significant impairment on executive tests. Memory impairment was associated with hippocampal/medial temporal damage on magnetic resonance imaging (MRI), and naming impairment with left temporal and left frontal abnormalities. Patients reported more subjective cognitive complaints than healthy controls, with tiredness a significant problem, and there were high rates of depression and anxiety in the HSV and the Other encephalitis groups. These subjective, self-reported complaints, depression, and anxiety persisted even after objectively measured neuropsychological performance had improved. Conclusions Neuropsychological and psychiatric outcomes after encephalitis vary according to aetiology. Memory and naming are severely affected in HSV, and less so in other forms. Neuropsychological functioning improves over time, particularly in those with more severe short-term impairments, but subjective cognitive complaints, depression, and anxiety persist, and should be addressed in rehabilitation programmes.
U2 - 10.1371/journal.pone.0230436
DO - 10.1371/journal.pone.0230436
M3 - Journal article
C2 - 32210460
AN - SCOPUS:85082380735
VL - 15
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 3
M1 - e0230436
ER -