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Neuropsychological deficits in Lyme disease patients with and without other evidence of central nervous system pathology.

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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.

Appl Neuropsychol. 1999;6(1):3-11. Comparative Study; Research Support, U.S. Gov’t, P.H.S.

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