Mc. Roberts et Ra. Emsley, COGNITIVE CHANGE AFTER TREATMENT FOR NEUROSYPHILIS - CORRELATION WITHCSF LABORATORY MEASURES, General hospital psychiatry, 17(4), 1995, pp. 305-309
The decision to re-treat a patient with neurosyphilis is usually based
on the clinical response, cerebrospinal fluid (CSF), cell count, and
CSF protein concentration. The value of the CSF Venereal Disease Resea
rch Laboratory (VDRL) test on its own as a marker for treatment respon
se in neurosyphilis has not been established. To assess the usefulness
of CSF markers for continuing infection, 12 patients with neurosyphil
is were reevaluated 1 year after treatment. Change in cognitive functi
oning, as assessed by the Mini-mental State Examination (MMSE), was co
rrelated with the CSF cell count, protein content, IgG index, and VDRL
test titer at follow-up. A significant negative correlation was obtai
ned between 1 year improvement in MMSE score and CSF VDRL titers at bo
th the 6- and the 12-month follow-up examinations, and with the 6-mont
h CSF protein concentration. These findings suggest that the CSF VDRL
titer may be an indicator of continued Treponema pallidum activity in
patients without obvious clinical deterioration.