Ī Johns Hopkins University School of Medicine brain PET imaging study (2018) revealed increased inflammation and glial activation in patients with Lyme-disease-associated persistent symptoms. Non-standard research-grade neuroimaging technologies have discovered marked biologic abnormalities in patients with Lyme disease as compared to healthy controls.Ī Columbia University brain PET imaging study (2009) found hypometabolism in Lyme-disease-associated encephalopathy. What does more advanced neuroimaging reveal? However, patient-reported cognitive complaints are subjective, and objective measures of cognitive decline are sought after by patients and clinicians. Working memory and processing speed have been shown to be impacted in Lyme disease patients using standardized neuropsychological measures. In some cases, the CSF fluid may show evidence of a mild form of encephalomyelitis, but this is rare.įormal cognitive testing with a neuropsychologist to characterize the type and severity of cognitive problems can be a more helpful approach.
Cerebrospinal fluid examination findings are usually normal as well. Serum blood testing for 2-tier IgG Borrelia burgdorferi antibody seropositivity may be negative in patients, such as those with past antibiotic treatment.Ĭlinically available MRI imaging is usually normal or shows nonspecific changes. Usual blood tests appear normal in Lyme encephalopathy or brain fog (CBC CMP: kidney, liver, glucose, thyroid ESR, CRP). What are the limitations of current clinical tests for Lyme-associated brain fog?īrain fog is commonly experienced by Lyme disease patients but difficult to detect because cognitive deficits can be too subtle for standard diagnostic tests to uncover. Mental fatigue is akin to how one feels after taking a long test that requires remembering detailed information or doing a complicated mental task when short on sleep. This includes quickly learning a new computer program or using names or numbers for a routine task.
Working memory enables one to do tasks quickly or easily solve a problem without looking up information. What does “brain fog” mean?īrain fog is a term used to describe difficulties with cognitive functions such as working memory, focusing, concentrating, planning, organizing, word recall, processing speed, and mental fatigue. These discoveries are significant but not yet well known by the physician community or broadly available to clinicians. Their findings indicate that Lyme-disease-associated brain alterations are biologic and measurable, not psychosomatic. Researchers have discovered, however, that by using more advanced imaging modalities, brain changes can be objectively detected in Lyme disease patients.įor example, clinical researchers at Johns Hopkins University School of Medicine have used novel PET imaging, functional MRI (fMRI), and diffusion tensor imaging (DTI) to identify inflammatory, functional, and structural abnormalities in the brains of Lyme disease patients as compared to healthy controls. Patients are often told by their health practitioners: “your tests are normal, it’s in your head” (aka psychosomatic ). Vexingly, these symptoms can be difficult to validate using current diagnostic tests. Persistent symptoms include severe fatigue, pain, and cognitive problems. Of these, an estimated 10-20% suffer from impairing symptoms well beyond the acute phase of infection. There are approximately 476,000 people diagnosed with Lyme disease annually in the US. Johns Hopkins Medicine Lyme Disease Research Center
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