Cognitive dysfunction in chronic Lyme disease confirmed with SPECT scan

An original study published by Donta et al (2012) confirmed abnormalities in about 75% of 183 patients studied with chronic Lyme disease. The frontal, temporal and parietal lobes were affected in those with abnormalities on SPECT scan with 15% of MRI studies showing abnormal.

This research was published ten years ago. Although we as clinicians know the cognitive dysfunction associated with chronic Lyme, the problem is lack of coverage for SPECT scans routinely despite the research available to support its use. MRIs are required by most insurance companies prior to ordering a SPECT scan. With merely 15% of MRIs showing abnormal, most patients will not be approved to receive a SPECT scan.

Patients with Lyme disease typically suffer from short-term memory deficits, concentration struggles, word retrieval and dyscalcula. Many have associated mood dysfunction that can lead to anxiety, depression, bipolar type disorders and hallucinations. SPECT scans measure cerebral perfusion and can correlate diagnostic findings with clinical presentation helping clinicians better manage patient’s symptoms.

The frontal lobe is the higher cognitive center controlling coordination, impulse control, decision making, linguistics, attention regulation, emotional regulation and development of personality. Damage to this area of the brain can influence gross and fine motor skills, personality disorders like multiple personality disorder development or bipolar disorder.

The temporal lobe controls short term memory centers, auditory processing, emotional regulation and language comprehension. Individuals with damage to this area may experience struggles with wordfinding, emotional lability and auditory overstimulation.

The parietal lobes control judgement, sensory processing, visual information, short term memory primarily. Those afflicted with damage to this area have difficulties processing things that they see and touch. Reading comprehension and mathematics in children are greatly affected. Recalling historical events of a person’s life may also be inhibited. Many patients with parietal lobe inflammation and damage suffer from judgement lapses and impulse control, taking major risks that are often dangerous.

The study by Donata et al (2012) also speaks to long term antibiotic therapy and the reversal of abnormalities observed on a SPECT scan. This data supports the hypothesis that cerebral abnormalities are secondary to a persistent infection.

Often, we see patients who carry a Lyme diagnosis and PANS or Autoimmune Encephalopathy. As you see, symptoms and areas of neuroinflammation overlap.

Just some food for thought!

Be Well!

Somer

Reference:

Donata, S. T., Noto, R.B., Vento, J.A. (2012). SPECT brain imaging in chronic lyme disease. Clinical Nuclear Medicine. 37, 9.