Lyme Neuroborreliosis and Dementia
Abstract
Introduction: Descriptions of Lyme disease and dementia are rare.
Objective: To describe patients with dementia and a positive “intrathecal anti-Borrelia antibody index” (AI), specific for neuroborreliosis.
Methods: Among 1,594 patients seen for dementia, we prospectively identified and studied 20 patients (1.25%) with dementia and a positive AI. Patients underwent a battery of neuropsychological tests brain, MRI, FDG-PET, and cerebrospinal fluid (CSF) analysis. An etiological diagnosis of the dementia was made at the end of the follow-up of 5.0 ± 2.9 years.
Results: We found two groups of patients with dementia, the first (n = 7, 0.44%) with certain neuroborreliosis and stability or mild improvement of dementia after treatment by antibiotics and the second (n = 13, 0.81%) with progressive worsening of dementia, despite the antibiotics. In the second group, the final diagnoses were Alzheimer’s disease (AD) (n = 4), AD and Lewy body disease (LBD) (n = 3), LBD (n = 1), FTLD (n = 3), hippocampal sclerosis (n = 1), and vascular dementia (n = 1). We did not observe any differences in cognitive test between the two patient groups at baseline. Brain MRI showed more focal atrophy and FDG-PET showed more frontal hypometabolism in the second group. Tau, p-tau, and Aβ42 concentrations in the CSF were normal in the neuroborreliosis group, and coherent with diagnosis in the second.
Conclusion: Pure Lyme dementia exists and has a good outcome after antibiotics. It is advisable to do Lyme serology in demented patients, and if serology is positive, to do CSF analysis with AI. Neurodegenerative dementia associated with positive AI also exists, which may have been revealed by the involvement of Borrelia in the CNS.
My wife was bitten by ticks in the summer of 2009 and that fall exhibited extreme personality changes. She had had no apparent reaction to the tick bites, no rash, fever, swelling etc. and we looked for other answers to her, at that time, mainly behavioral issues. In 2012 a physician asked if she had ever been tested for Lyme, she had not, so we found a doctor who sent her blood to Igenics in California and it came back positive for long term exposure. I gave her infusions of Rosepheren (sp) for several weeks but the damage had in all likelihood been done. Fast forward thru many health challenges with memory etc. to where we are now with a physician at Johns Hopkins telling me she had frontal temporal dementia.
Is there a possibility Lyme or the results thereof are involved ?