Predictive Values of CSF Ferritin in Cognitive Assessment of Patients after Acute Central Nervous System Infections

CNS infections represent a unique challenge to clinicians due to significant morbidity and mortality. The role of ferritin as a reactant of various pathological conditions is currently being intensively investigated. The pathogenesis of cognitive impairment after acute neuroinfectious disease is not yet fully understood. It is believed to be a direct consequence of neuronal damage by the infection, but also by the activation of immunocompetent brain cells, with consequent disruption of signal conduction in a varying period of time after the infection has resolved. The aim of the study is to examine the prediction of ferritin on the degree of cognitive impairment in patients who have suffered from a CNS infection. The values of CSF ferritin were evaluated in three analyzed groups of subjects (bacterial, viral and group with normal CSF findings - meningism). The analyzed clinical data were correlated with the degree of neurocognitive impairment, and the relationship between CSF ferritin and the degree of cognitive impairment was analyzed. The conducted research is a retrospective-prospective analytical and clinical study that was conducted in the period from 01.01.2017 to 01.01.2020. The research includes 90 patients according to previously nominated criteria, divided into three groups, two “examined” and one “control”. The assessment of the cognitive status of the subjects was performed using the MMSE test. The SPSS for Windows software package (version 20.0, SPSS INC, Chicago, Illinois, USA) was used for statistical analysis of the obtained data. We confirmed that the CSF protein ferritin is a good predictor of distinguishing purulent from viral meningitis / meningoencephalitis. The obtained results did not confirm the hypothesis that elevated CSF ferritin values have a negative impact on cognition. Impairment of individual domains of cognition measured by MMSE I, such as “attention”, “calculation” and “memory” are more pronounced in purulent CNS infections. Impairment of individual domain MMSE II “calculation” is more pronounced in the purulent CNS infection category