Lyme Disease Causes Brain Inflammation Which Leads to Memory Trouble, Personality Disorders, and Anything Involving the Brain
A review of some chat rooms trashes every major physician treating tick infections regardless of their cost, treatment style or personality. This has hardly gone unnoticed by physicians treating the worst medically ill patients. Moreover, it has caused them to be very careful. It has caused many to retire or stop the treatment of Lyme, Babesia and Bartonella at all or aggressively.
Alice has an IQ of over 130. After getting some tick bites in the back yard of some relatives in New Jersey, she slowly had a decreased memory over a year. No one could find the cause. She was eventually diagnosed with Lyme by advanced 2010 medicine. Perhaps this sounds arrogant and prideful—it was not my patient.
Lynn was bitten by a few deer ticks and suddenly because hostile, angry and hateful. People were nice or devils. This was all subtle and hidden when she was with casual friends. It was clear to her spouse. "What happened to my nice wife?" Now she spends all her time on chat rooms and some of what she writes is a waste of time. She has better things to do! She writes bad things about the two physicians she went to see because they were very clear they did not take our insurance. What is going on! I want my sane, sweet and kind wife back."
Am J Med. 2009 Sep;122(9):843-50.
Psychiatric comorbidity and other psychological factors in patients with "chronic Lyme disease".
Hassett AL, Radvanski DC, Buyske S, Savage SV, Sigal LH.
Division of Rheumatology and Connective Tissue Research, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA. firstname.lastname@example.org
BACKGROUND: There is no evidence of current or previous Borrelia burgdorferi infection in most patients evaluated at university-based Lyme disease referral centers. Instead, psychological factors likely exacerbate the persistent diffuse symptoms or "Chronic Multisymptom Illness" (CMI) incorrectly ascribed to an ongoing chronic infection with B. burgdorferi. The objective of this study was to assess the medical and psychiatric status of such patients and compare these findings to those from patients without CMI. METHODS: There were 240 consecutive patients who underwent medical evaluation and were screened for clinical disorders (eg, depression and anxiety) with diagnoses confirmed by structured clinical interviews at an academic Lyme disease referral center in New Jersey. Personality disorders, catastrophizing, and negative and positive affect also were evaluated, and all factors were compared between groups and with functional outcomes. RESULTS: Of our sample, 60.4% had symptoms that could not be explained by current Lyme disease or another medical condition other than CMI. After adjusting for age and sex, clinical disorders were more common in CMI than in the comparison group (P <.001, odds ratio 3.54, 95% confidence interval, 1.97-6.55), but personality disorders were not significantly more common. CMI patients had higher negative affect, lower positive affect, and a greater tendency to catastrophize pain (P <.001) than did the comparison group. Except for personality disorders, all psychological factors were related to worse functioning. Our explanatory model based on these factors was confirmed. CONCLUSIONS: Psychiatric comorbidity and other psychological factors are prominent in the presentation and outcome of some patients who inaccurately ascribe longstanding symptoms to "chronic Lyme disease."
PMCID: 2751626 PMID: 19699380 [PubMed - indexed for MEDLINE]
Arthritis Rheum. 2008 Dec 15;59(12):1742-9.
Role of psychiatric comorbidity in chronic Lyme disease.
Hassett AL, Radvanski DC, Buyske S, Savage SV, Gara M, Escobar JI, Sigal LH.
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA. email@example.com
OBJECTIVE: To evaluate the prevalence and role of psychiatric comorbidity and other psychological factors in patients with chronic Lyme disease (CLD). METHODS: We assessed 159 patients drawn from a cohort of 240 patients evaluated at an academic Lyme disease referral center. Patients were screened for common axis I psychiatric disorders (e.g., depressive and anxiety disorders); structured clinical interviews confirmed diagnoses. Axis II personality disorders, functional status, and traits like negative and positive affect and pain catastrophizing were also evaluated. A physician blind to psychiatric assessment results performed a medical evaluation. Two groups of CLD patients (those with post-Lyme disease syndrome and those with medically unexplained symptoms attributed to Lyme disease but without Borrelia burgdorferi infection) were compared with 2 groups of patients without CLD (patients recovered from Lyme disease and those with an identifiable medical condition explaining symptoms attributed to Lyme disease). RESULTS: After adjusting for age and sex, axis I psychiatric disorders were more common in CLD patients than in comparison patients (P = 0.02, odds ratio 2.64, 95% confidence interval 1.30-5.35), but personality disorders were not. Patients with CLD had higher negative affect, lower positive affect, and a greater tendency to catastrophize pain (P < 0.001) than comparison patients. All psychological factors except personality disorders were related to level of functioning. A predictive model based on these psychological variables was confirmed. Fibromyalgia was diagnosed in 46.8% of CLD patients. CONCLUSION: Psychiatric comorbidity and other psychological factors distinguished CLD patients from other patients commonly seen in Lyme disease referral centers, and were related to poor functional outcomes.
PMID: 19035409 [PubMed - indexed for MEDLINE]
MMW Fortschr Med. 2006 Nov 9;148(45):8.
[Neuroborreliosis or borrelia hysteria. This case becomes a nightmare!]
[Article in German]
Universit�tsklinik, f�r Dermatologie, Medizinische Universit�t Graz, Auenmbrugger Platz 8, A-8036 Graz, Osterreich.
PMID: 17615738 [PubMed - indexed for MEDLINE]
Neurology. 2003 Jun 24;60(12):1916-22.
Cognitive function in post-treatment Lyme disease: do additional antibiotics help?
Kaplan RF, Trevino RP, Johnson GM, Levy L, Dornbush R, Hu LT, Evans J, Weinstein A, Schmid CH, Klempner MS.
University of Connecticut School of Medicine, Farmington, USA. firstname.lastname@example.org
Comment in: Neurology. 2003 Jun 24;60(12):1888-9.
BACKGROUND: It is controversial whether additional antibiotic treatment will improve cognitive function in patients with post-treatment chronic Lyme disease (PTCLD). OBJECTIVE: To determine whether antibiotic therapy improves cognitive function in two randomized double-blind placebo-controlled studies of patients with PTCLD. METHODS: A total of 129 patients with a physician-documented history of Lyme disease from three study sites in the northeast United States were studied. Seventy-eight were seropositive for IgG antibodies against Borrelia burgdorferi, and 51 were seronegative. Patients in each group were randomly assigned to receive IV ceftriaxone 2 g daily for 30 days followed by oral doxycycline 200 mg daily for 60 days or matching IV and oral placebos. Assessments were made at 90 and 180 days after treatment. Symptom severity was measured from the cognitive functioning, pain, and role functioning scales of the Medical Outcomes Study (MOS). Memory, attention, and executive functioning were assessed using objective tests. Mood was assessed using the Beck Depression Inventory and Minnesota Multiphasic Personality Inventory. RESULTS: There were no significant baseline differences between seropositive and seronegative groups. Both groups reported a high frequency of MOS symptoms, depression, and somatic complaints but had normal baseline neuropsychological test scores. The combined groups showed significant decreases in MOS symptoms, higher objective test scores, and improved mood between baseline and 90 days. However, there were no significant differences between those receiving antibiotics and placebo. CONCLUSION: Patients with post-treatment chronic Lyme disease who have symptoms but show no evidence of persisting Borrelia infection do not show objective evidence of cognitive impairment. Additional antibiotic therapy was not more beneficial than administering placebo.
PMID: 12821733 [PubMed - indexed for MEDLINE]
J Neuropsychiatry Clin Neurosci. 2001 Fall;13(4):500-7.
A controlled study of cognitive deficits in children with chronic Lyme disease.
Tager FA, Fallon BA, Keilp J, Rissenberg M, Jones CR, Liebowitz MR.
Columbia University Department of Psychiatry, Division of Behavioral Medicine, New York, New York 10032, USA. email@example.com
Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed.
PMID: 11748319 [PubMed - indexed for MEDLINE]
Soc Sci Med. 2000 Sep;51(5):657-68.
Concepts of trust among patients with serious illness.
Mechanic D, Meyer S.
Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ 08901, USA.
This paper examines conceptions of trust among three groups of respondents diagnosed with either breast cancer, Lyme disease or mental illness. Interviews were carried out using an open-ended interview guide to explore how patients made assessments of trust in their doctors and health care plans. The guide followed a conceptual approach that asked questions about competence, agency/fiduciary responsibility, control, disclosure and confidentiality. Respondents were given ample opportunity to raise other areas of concern. The data were organized using the NUDIST software package for the analysis of non-numerical and unstructured qualitative data. Patients viewed trust as an iterative process and commonly tested their physicians against their knowledge and expectations. Interpersonal competence, involving caring, concern and compassion, was the most common aspect of trust reported, with listening as a central focus. Most patient comments referred to learnable skills and not simply to personality characteristics. Technical competence also received high priority but was often assessed by reputation or interpersonal cues. Patients were much concerned that doctors be their agents and fight for their interests with health care plans. Disclosure and confidentiality were less common concerns; most patients anticipated that doctors would be honest with them and respect their confidences. Patients' responses also appeared to vary by their disease, their socio-demographic characteristics, their involvement with self-help groups, and how their illness conditions unfolded.
PMID: 10975226 [PubMed - indexed for MEDLINE]
Appl Neuropsychol. 1999;6(1):3-11.
Neuropsychological deficits in Lyme disease patients with and without other evidence of central nervous system pathology.
Kaplan RF, Jones-Woodward L, Workman K, Steere AC, Logigian EL, Meadows ME.
Department of Neurology, Tufts University School of Medicine, Boston, Massachusetts, USA.
A small percentage of Lyme patients develop mild to moderate encephalopathic symptoms months to years after diagnosis and treatment. Their symptoms typically include fatigue, memory loss, sleep disturbance, and depression. However, the etiology of this syndrome remains controversial. It is generally thought that Lyme patients with abnormal cerebral spinal fluid (CSF) have a neurological basis to their illness. To further examine this question, we compared Lyme patients with evidence of abnormal CSF, intrathecal antibody to Borrelia burgdorferi, elevated protein, or a positive polymerase chain reaction for B. burgdorferi DNA (n = 14); Lyme patients with normal CSF (n = 18); and healthy controls (n = 15) on a battery of neuropsychological and personality tests. Although both Lyme groups reported memory problems, only the Lyme group with abnormal CSF had measurable memory deficits. Both Lyme groups had higher depression scores than the normal control group, although depression was not correlated with memory scores. It appears that Lyme patients with abnormal CSF may have a neurological basis to their illness, whereas affective symptoms, common to many chronic disorders, may predispose other Lyme patients to the perception of cognitive dysfunction.
PMID: 10382565 [PubMed - indexed for MEDLINE]
J Clin Psychiatry. 1996 Jul;57(7):282-6.
Memory functioning in Lyme borreliosis.
Ravdin LD, Hilton E, Primeau M, Clements C, Barr WB.
Department of Medicine, Division of Infectious Diseases, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
BACKGROUND: To objectively measure memory functioning in patients with Lyme borreliosis and examine the relationship between subjective reports of memory dysfunction and actual impairment. METHOD: A prospective pretreatment study of patients with Lyme borreliosis (N = 21), a patient control group (osteomyelitis, N = 21), and healthy controls (N = 21) was conducted by using tests of verbal memory functioning (California Verbal Learning Test) and self-reported depression (Beck Depression Inventory-Cognitive Index), fatigue (Fatigue Severity Scale), and subjective ratings of memory abilities (Self-Rating Scale of Memory Functions). RESULTS: Patients with Lyme borreliosis performed worse than healthy controls on verbal memory testing, but did not perform significantly differently from patient controls. Lyme borreliosis patients reported increased fatigue, which was correlated with poorer memory performance. Although the Lyme borreliosis patients rated their memory as more impaired, subjective complaints were not correlated with objective memory scores. CONCLUSION: These findings suggest impaired memory performance is not specific to Lyme borreliosis and may be a result of evaluating cognitive functioning in patients with physical illness and somatic complaints. Fatigue is a prominent presenting complaint in patients with Lyme borreliosis and needs to be controlled for since it is known to influence neuropsychological performance. Subjective complaints are not correlated with objective memory assessment, so self-report of memory impairment should not be the criterion for inclusion in studies investigating cognitive manifestations of Lyme borreliosis.
PMID: 8666568 [PubMed - indexed for MEDLINE]
Neurology. 1992 Jul;42(7):1263-7.
Memory impairment and depression in patients with Lyme encephalopathy: comparison with fibromyalgia and nonpsychotically depressed patients.
Kaplan RF, Meadows ME, Vincent LC, Logigian EL, Steere AC.
Department of Neurology, Tufts University School of Medicine, New England Medical Center, Boston, MA 02111.
Lyme encephalopathy, primarily manifested by disturbances in memory, mood, and sleep, is a common late neurologic manifestation of Lyme disease. We compared 20 patients with Lyme encephalopathy with 11 fibromyalgia patients and 11 nonpsychotically depressed patients using the California Verbal Learning Test, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Minnesota Multiphasic Personality Inventory (MMPI), and Beck Depression Inventory. Compared with patients with fibromyalgia or depression, the Lyme encephalopathy group showed mild, but statistically significant, memory deficits on two of the three memory tests. In contrast, the patients with fibromyalgia scored significantly higher than both other groups on the MMPI scale most sensitive to somatic concerns (scale 1), while the depressed patients scored higher than the Lyme patients on the scales most sensitive to depression (scale 2) and anxiety (scale 7). Physical complaints and depression were not major factors in memory performance among Lyme patients. These data support the hypothesis that Lyme encephalopathy is caused by CNS dysfunction and cannot be explained as a psychological response to chronic illness.
PMID: 1620329 [PubMed - indexed for MEDLINE]
Nervenarzt. 1989 Feb;60(2):115-9.
[Borrelia encephalitis and catatonia in adolescence]
[Article in German]
Neum�rker KJ, Dudeck U, Plaza P.
Abteilung f�r Psychiatrie und Neurologie des Kindes- und Jugendalters, Humboldt-Universit�t zu Berlin.
PMID: 2716930 [PubMed - indexed for MEDLINE]