December 28, 2007
The following description of this study, to be led by Lyme expert Brian A. Fallon, MD, is taken from the Columbia Lyme Research website: http://www.columbia-lyme.org/flatp/resstud.html
[Note: You can read about Dr. Fallon’s most recent study, reported in October 2007 – “Columbia University Medical Center Researchers Lead Placebo-Controlled Study of Cognitive Impairment Among Patients With Previously Treated Lyme Disease” at http://www.immunesupport.com/library/showarticle.cfm?id=8445 ]
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Participants: People with chronic Lyme Disease ages 18-60
Goals:
1) To examine differences between SPECT images of Lyme disease vs psychiatric disorders.
2) To determine how consistently brain imaging experts can distinguish the SPECT scans of patients with Lyme Disease from the SPECT scans of patients with depression and patients with anxiety disorders.
Status of study: Currently recruiting
Principal Investigator: Brian A. Fallon, MD
Design: This study is supported by funds from the Lyme Disease Association and from the Wilton Lyme Disease Task Force. Patients with a history of erythema migrans positive or seropositive Lyme Disease and typical manifestations of Lyme Disease who have persistent cognitive problems despite prior treatment will be recruited. The brain SPECT scans of the Lyme patients will be compared to age- and sex-matched controls. Controls will consist of patients with depression and patients with an anxiety disorder.
Frequently asked question: Why is this study needed?
One of the more difficult diagnostic areas is to determine whether a patient is suffering from a primary psychiatric disorder or a secondary neuropsychiatric disorder as a result of a primary neurologic condition.
Because patients with central nervous system involvement of Lyme Disease may develop irritability, mood swings, sleep disorder, cognitive problems, marked fatigue, low sexual interest, pain, and anhedonia, these patients may easily be misdiagnosed as having primary depression.
As one tool to assist in the differential diagnosis, a SPECT scan is often ordered. The assumption is that if the brain SPECT reveals a pattern of global decreased perfusion in a heterogeneous pattern then the patient is more likely to have had CNS involvement as a result of Lyme disease.
The pattern in depression would be more likely one of decreased perfusion only in the frontal lobes. The pattern in OCD would be increased perfusion in the orbitofrontal cortex or basal ganglia.
The questions we wish to ask are:
a) Are these assumptions accurate using the technology of HMPAO SPECT?;
b) Are the nuclear medicine physicians capable of differentiating (blind to diagnosis) whether a scan comes from a patient with Lyme Disease or from a patient with a primary psychiatric disorder alone?<
Contact for further info: If you wish further info about the study, send an e-mail to CULyme@aol.com
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