SPECT brain imaging in chronic Lyme disease.
Clin Nucl Med. 2012 Sep;37(9):e219-22. doi: 10.1097/RLU.0b013e318262ad9b
Abstract
OBJECTIVES:
Lyme disease is an infectious disease that frequently involves the central nervous system, leading to cognitive and/or mood dysfunction. The basis for these symptoms remains to be defined but may be the result of a vasculitis or metabolic abnormality secondary to the infection. SPECT scans of the brain might provide an objective measure of abnormalities present in patients with otherwise difficult to objectify clinical findings. The objective of this study was to determine the frequency, location, and severity of abnormalities in SPECT scans of the brain of patients with chronic Lyme disease.
METHODS:
A total of 183 individuals who met the clinical definition of chronic Lyme disease underwent SPECT scanning of the brain using Tc and standard nuclear imagine techniques. Abnormalities of perfusion to affected areas of the brain were defined as mild, moderate, or severe.
RESULTS:
Of all patients, 75% demonstrated abnormalities in perfusion to various areas of the brain, most notably the frontal, temporal, and parietal lobes. Patients considered to be seropositive and those considered seronegative had similar rates, types, and severity of perfusion defects. Abnormalities of MRI of the brain were seen in 14% of patients. Treatment with antibiotics, especially those with intracellular-penetrating activity, resulted in resolution or improvement of abnormalities in 70% of patients over a 1- to 2-year period.
CONCLUSIONS:
Brain SPECT scans are abnormal in most patients with chronic Lyme disease, and these scans can be used to provide objective evidence in support of the clinical diagnosis. The use of certain antibiotic regimens seems to provide improvement in both clinical status and SPECT scans.
We have had two SPECTS with hypoperfusion as described above, had bright spots on MRIs, elevated protein levels in CSF from 5 spinal taps over 5 yrs, and 1.5 yrs of intracellular and deep tissue focused antibiotics with subsequent recoveries and would confirm all the findings of this research. thank you, Jimmy Branch
My only regret was that it took 5 yrs to get the correct abx, over $1,000,000 in healthcare costs, of which, over $300,000 was cash.
I had a spect scan due to behavioral changes resulting in difficulties at work and home as well as a history of 3 head injuries resulting in concussion. The scan results were similar to the study and I was told I had a very sick brain. I was later diagnosed with Lyme disease and have been in treatment which has made some difference in my symptoms. Two questions; should I question my traumatic brain injury diagnosis and ask for a follow up scan to see if there is a difference since my first? Secondly, you say in your conclusions that scan outcomes can be used to provide objective evidence in the diagnosis but since medical and insurance don’t recognize the diagnosis of chronic Lyme that appears to cause changes in the brain who else is going to care? I can see however it may help in getting system wide change by presenting the outcomes to those who need to have a better understanding of the disease severity, i.e.-government leaders, medical community, insurance regulators, etc. Great study can’t wait to see more.
I have had serial SPECT scans using the same facility over the past 23 years for eval. of cognitive issues w/ chronic lyme. I am having an unusual flare of the neuro and cognitive symptoms but cannot seem to convince my docs that even though my last SPECT scan over 3 years ago showed severe hypo perfusion to bilateral parietal lobes AND new evidence of white matter disease… with symptoms worse now then they were then… nobody seems to be willing to order this test for me. I know the information especially in light of a new pos. lyme western blot IGM would be valuable since it appears we have a new baseline. instead I am being told by ID docs that I do not have lyme. SPECT scans have shed so much light on my functioning through the years and I have noticed that when treated with antibiotics, the perfusion does improve. Hopefully I will have the opportunity to prove this again… maybe?