title: Cognitive and emotional changes in neurobrucellosis.
abstract: OBJECTIVE
  To determine cognitive and emotional changes among neurobrucellosis patients.
  
  
  METHODS
  The patients with neurobrucellosis and controls with brucellosis without neurologic involvement were included in the study. Neurobrucellosis was diagnosed by the following criteria: (i) symptoms or clinical findings compatible with neurobrucellosis, including headache, confusion, mental and emotional changes; (ii) isolation of Brucella spp. from CSF and/or demonstration of antibodies to Brucella > or = 1/4 in the CSF; (iii) the presence of lymphocytosis, increased protein and decreased glucose levels in the CSF; and (iv) clinical improvement with appropriate treatment. Two psychiatrists interviewed the patients, and performed the Hamilton Depression Rating Scale (HDRS) tests and Mini-Mental State Examination (MMSE) tests.
  
  
  RESULTS
  Thirty-four neurobrucellosis cases and 30 patients with brucellosis without neurological involvement were studied. The mean age was 41 years, 12 (41%) patients were female, 13 (46%) patients were farmers, and 7 (25%) patients were housewives. Among the neurobrucellosis cases, before the antibiotic therapy, the mean MMSE test score was 21.6, one week after the therapy 22.7, and two weeks after the therapy 24.3 (p=0.024, and p<0.001, respectively). At the day of admission before therapy, the mean of HDRS test was 9.9, one week after therapy it was 7.8, and two weeks after therapy it was 5 (p=0.014, and p<0.001, respectively).
  
  
  CONCLUSIONS
  The cognitive and emotional disturbances among neurobrucellosis patients were documented by MMSE and HDRS tests. These disorders improve by antibiotic therapy, without any anti-depressive or anti-psychotic therapy.
authors.affiliation: The First Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Talatpasa bulvari, Sihhiye, 06230, Ankara, Turkey. sebnemeren@yahoo.com
authors.forename: Sebnem
authors.initials: S
authors.lastname: Eren
authors.forename: Göksel
authors.initials: G
authors.lastname: Bayam
authors.forename: Onder
authors.initials: O
authors.lastname: Ergönül
authors.forename: Aysel
authors.initials: A
authors.lastname: Celikbaş
authors.forename: Ozan
authors.initials: O
authors.lastname: Pazvantoğlu
authors.forename: Nurcan
authors.initials: N
authors.lastname: Baykam
authors.forename: Başak
authors.initials: B
authors.lastname: Dokuzoğuz
authors.forename: Nesrin
authors.initials: N
authors.lastname: Dilbaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002006:Brucellosis / Q000150:complications / Q000503:physiopathology*; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests