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Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy.

Publication ,  Journal Article
Fallon, BA; Lipkin, RB; Corbera, KM; Yu, S; Nobler, MS; Keilp, JG; Petkova, E; Lisanby, SH; Moeller, JR; Slavov, I; Van Heertum, R; Mensh, BD ...
Published in: Arch Gen Psychiatry
May 2009

CONTEXT: There is controversy regarding whether objective neurobiological abnormalities exist after intensive antibiotic treatment for Lyme disease. OBJECTIVES: To determine whether patients with a history of well-characterized Lyme disease and persistent cognitive deficit show abnormalities in global or topographic distributions of regional cerebral blood flow (rCBF) or cerebral metabolic rate (rCMR). DESIGN: Case-controlled study. SETTING: A university medical center. PARTICIPANTS: A total of 35 patients and 17 healthy volunteers (controls). Patients had well-documented prior Lyme disease, a currently reactive IgG Western blot, prior treatment with at least 3 weeks of intravenous cephalosporin, and objective memory impairment. MAIN OUTCOME MEASURES: Patients with persistent Lyme encephalopathy were compared with age-, sex-, and education-matched controls. Fully quantified assessments of rCBF and rCMR for glucose were obtained while subjects were medication-free using positron emission tomography. The CBF was assessed in 2 resting room air conditions (without snorkel and with snorkel) and 1 challenge condition (room air enhanced with carbon dioxide, ie, hypercapnia). RESULTS: Statistical parametric mapping analyses revealed regional abnormalities in all rCBF and rCMR measurements that were consistent in location across imaging methods and primarily reflected hypoactivity. Deficits were noted in bilateral gray and white matter regions, primarily in the temporal, parietal, and limbic areas. Although diminished global hypercapnic CBF reactivity (P < .02) was suggestive of a component of vascular compromise, the close coupling between CBF and CMR suggests that the regional abnormalities are primarily metabolically driven. Patients did not differ from controls on global resting CBF and CMR measurements. CONCLUSIONS: Patients with persistent Lyme encephalopathy have objectively quantifiable topographic abnormalities in functional brain activity. These CBF and CMR reductions were observed in all measurement conditions. Future research should address whether this pattern is also seen in acute neurologic Lyme disease.

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Published In

Arch Gen Psychiatry

DOI

EISSN

1538-3636

Publication Date

May 2009

Volume

66

Issue

5

Start / End Page

554 / 563

Location

United States

Related Subject Headings

  • Regional Blood Flow
  • Reference Values
  • Psychiatry
  • Positron-Emission Tomography
  • Oxygen Radioisotopes
  • Oxygen Consumption
  • Neuropsychological Tests
  • Neurologic Examination
  • Middle Aged
  • Memory Disorders
 

Citation

APA
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ICMJE
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Fallon, B. A., Lipkin, R. B., Corbera, K. M., Yu, S., Nobler, M. S., Keilp, J. G., … Sackeim, H. A. (2009). Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy. Arch Gen Psychiatry, 66(5), 554–563. https://doi.org/10.1001/archgenpsychiatry.2009.29
Fallon, Brian A., Richard B. Lipkin, Kathy M. Corbera, Shan Yu, Mitchell S. Nobler, John G. Keilp, Eva Petkova, et al. “Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy.Arch Gen Psychiatry 66, no. 5 (May 2009): 554–63. https://doi.org/10.1001/archgenpsychiatry.2009.29.
Fallon BA, Lipkin RB, Corbera KM, Yu S, Nobler MS, Keilp JG, et al. Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy. Arch Gen Psychiatry. 2009 May;66(5):554–63.
Fallon, Brian A., et al. “Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy.Arch Gen Psychiatry, vol. 66, no. 5, May 2009, pp. 554–63. Pubmed, doi:10.1001/archgenpsychiatry.2009.29.
Fallon BA, Lipkin RB, Corbera KM, Yu S, Nobler MS, Keilp JG, Petkova E, Lisanby SH, Moeller JR, Slavov I, Van Heertum R, Mensh BD, Sackeim HA. Regional cerebral blood flow and metabolic rate in persistent Lyme encephalopathy. Arch Gen Psychiatry. 2009 May;66(5):554–563.

Published In

Arch Gen Psychiatry

DOI

EISSN

1538-3636

Publication Date

May 2009

Volume

66

Issue

5

Start / End Page

554 / 563

Location

United States

Related Subject Headings

  • Regional Blood Flow
  • Reference Values
  • Psychiatry
  • Positron-Emission Tomography
  • Oxygen Radioisotopes
  • Oxygen Consumption
  • Neuropsychological Tests
  • Neurologic Examination
  • Middle Aged
  • Memory Disorders