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Review: Impact of “Long Standing” Lyme Disease on Neuropsychiatric and Cognitive Symptoms
Cureus (Brackett, M., et al.) 04.15.2024 published a review article, “Neuropsychiatric Manifestations and Cognitive Decline in Patients With Long-Standing Lyme Disease: A Scoping Review.” Researchers utilized the electronic databases Embase, Ovid Medical Literature Analysis and Retrieval System Online (MEDLINE), and Web of Science to conduct a review of articles regarding neuropsychiatric manifestations and cognitive dysfunction in patients with Long-Standing Lyme Disease (LSLD). For this review, the acronym LSLD is used to include all definitions of chronic and/or late stage Lyme disease, including post-treatment Lyme disease syndrome (PTLDS).
A rigorous screening process was used to assess the 744 articles populated through the database search. Of the 744 articles considered for inclusion, only 10 met the inclusion criteria for this review. The review included articles that reported neuropsychiatric manifestations and cognitive decline in patients with “Long Standing Lyme Disease” (LSLD) and the effects of a delayed diagnosis.
Suicidal ideation, homicidal tendencies, extreme anger, depressive symptoms, aggression, and anxiety were among the neuropsychiatric manifestations documented in patients with LSLD. Dysfunctions in working memory, verbal learning/memory, non-verbal learning/memory, alertness, visuoconstructive (the coordination of fine motor skills with spatial abilities, usually in the reproduction of geometric figures), and frontal executive functioning were noted for patients with cognitive symptoms/decline. Other symptoms of late stage Lyme disease can include brain fog, schizophrenia, major depression, panic attacks, and obsessive compulsive disorder. Delay in diagnosis of Lyme disease in most patients was associated with an increase of symptom severity.
Researchers report that Lyme disease is often overlooked in the differential diagnosis of patients with neuropsychiatric symptoms and cognitive decline. Neuropsychiatric and cognitive symptoms were found to persist even after treatment and presumed “disease resolution.” Investigators stress the need for additional research to compare the time to diagnosis of Lyme disease and the severity of symptoms in patients with LSLD.
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