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The Neuropsychiatric Assessment of Lyme Disease by
Robert Bransfield, M.D.
Clinical assessment includes a structured interview to assist when late state Lyme disease is suspected.
Distinct Pattern of Cognitive Impairment noted in study of Lyme
patients (
pdf)
Higher Prevalence of Antibodies to Borrelia Burgdorferi
in Psychiatric Patients Than in Healthy Subjects -
(Am J
Psychiatry 2002; 159:297–301)
(
pdf)
Lyme Disease in Schools: Etiology, Neuropsychological Sequelae, and Educational Impact (Newspaper of the National Association of School Psychologists 2007 Feb;
Vol 35, Num 5: 34-36)
Citations - Lyme Disease and Cognitive Defecits:
WAIS-III and WMS-III performance in chronic Lyme disease.J Int Neuropsychol Soc. 2006 Jan;12(1):119-29.
Keilp JG, Corbera K, Slavov I, Taylor MJ, Sackeim HA, Fallon BA.
Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, New York 10032, USA. jgk13@columbia.edu
There is controversy regarding the nature and degree of intellectual and memory deficits in chronic Lyme disease. In this study, 81 participants with rigorously diagnosed chronic Lyme disease were administered the newest revisions of the Wechsler Adult Intelligence Scale (WAIS-III) and Wechsler Memory Scale (WMS-III), and compared to 39 nonpatients. On the WAIS-III, Lyme disease participants had poorer Full Scale and Performance IQ's. At the subtest level, differences were restricted to Information and the Processing Speed subtests. On the WMS-III, Lyme disease participants performed more poorly on Auditory Immediate, Immediate, Auditory Delayed, Auditory Recognition Delayed, and General Memory indices. Among WMS-III subtests, however, differences were restricted to Logical Memory (immediate and delayed) and Family Pictures (delayed only), a Visual Memory subtest. Discriminant analyses suggest deficits in chronic Lyme are best characterized as a combination of memory difficulty and diminished processing speed. Deficits were modest, between one-third and two-thirds of a standard deviation, consistent with earlier studies. Depression severity had a weak relationship to processing speed, but little other association to test performance. Deficits in chronic Lyme disease are consistent with a subtle neuropathological process affecting multiple performance tasks, although further work is needed to definitively rule out nonspecific illness effects. (Source: PubMed)
A controlled study of cognitive deficits in
children with chronic Lyme disease.
Full text
J Neuropsychiatry
Clin Neurosci. 2001
Fall;13(4):500-7.
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. ft49@columbia.edu
Although neurological 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.
(Source: PubMed)
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