NEUROPSYKIATRINEN BORRELIOOSI

[soijuv]

Tieteellisiä tutkimuksia borreliabakteerin ja psyykkisten oireiden yhteydestä.


References for Psychiatry
and Lyme/Tick-Borne Diseases

http://www.lymeinfo.net/psychbiblio.html

This is a list of references in the medical/scientific literature on psychiatry and Lyme/tick-borne disease. Dr Brian Fallon has published more than any other single author in the peer reviewed literature. Below are some of his articles and some other peer reviewed articles:

Acute disseminated encephalomyelitis [letter]
AUTHORS: Fallon BA, Nields JA.
SOURCE: J Neuropsychiatry Clin Neurosci 1998 Summer;10(3):366-7

The association between tick-borne infections, Lyme borreliosis and autism spectrum disorders
AUTHORS: Bransfield RC, Wulfman JS, Harvey WT, Usman AI
SOURCE: Medical Hypotheses. 5 Nov 2007

Audiologic manifestations of patients with post-treatment Lyme disease syndrome
AUTHORS: Shotland LI, Mastrioanni MA, Choo DL, Szymko-Bennett YM, Dally LG, Pikus AT, Sledjeski K, Marques A
SOURCE: Ear Hear. 2003 Dec;24(6):508-17

Borrelia burgdorferi central nervous system infection presenting as an organic schizophrenialike disorder.
AUTHORS: Hess A, Buchmann J, Zettl UK, Henschel S, Schlaefke D, Grau G, Benecke R.
SOURCE: Biol Psychiatry 1999 Mar 15;45(6):795

Borrelia burgdorferi-seropositive chronic encephalomyelopathy: Lyme neuroborreliosis? An autopsied report.
AUTHORS: Kobayashi K, Mizukoshi C, Aoki T, Muramori F, Hayashi M, Miyazu K, Koshino Y, Ohta M, Nakanishi I, Yamaguchi N.
SOURCE: Dement Geriatr Cogn Disord. 1997 Nov-Dec;8(6):384-90.

Brain SPECT Imaging in Chronic Lyme Disease.
AUTHORS: Plutchok JJ, Tikofsky RS, Liegner KB, Fallon BA, Van Heertum RL.
SOURCE: Journal of Spirochetal and Tick Borne-Diseases, 1999; 6: 10-16.

Carbamazepine in the treatment of Lyme disease-induced hyperacusis.
AUTHORS: Nields JA, Fallon BA, Jastreboff PJ.
SOURCE: J Neuropsychiatry Clin Neurosci 1999 Winter;11(1):97-9

Central nervous system manifestations of human ehrlichiosis.
AUTHORS: Ratnasamy N, Everett ED, Roland WE, McDonald G, Caldwell CW.
SOURCE: Clin Infect Dis 1996 Aug;23(2):314-9

Cerebral metabolic changes associated with Lyme disease
AUTHORS: Newberg A, Hassan A, Alavi A.
SOURCE: Nucl Med Commun 2002 August;23(8 ):773-777

Chronic neurologic manifestations of erythema migrans borreliosis.
AUTHORS: Ackermann R, Rehse-Kupper B, Gollmer E, Schmidt R.
SOURCE: Ann N Y Acad Sci. 1988;539:16-23.

Co-existance of toxoplasmosis and neuroborreliosis - a case report.
AUTHORS: Gustaw K, Beltowska K, Dlugosz E.
SOURCE: Ann Agric Environ Med. 2005;12(2):305-8.

Cognitive processing speed in Lyme disease.
AUTHORS: Pollina DA, Sliwinski M, Squires NK, Krupp LB.
SOURCE: Neuropsychiatry Neuropsychol Behav Neurol. 1999 Jan;12(1):72-8.

Constipation Heralding Neuroborreliosis
AUTHORS: Shamim A, Shamim S; Liss G; Nylen E; Pincus J; Yepes M.
SOURCE: Arch Neurol. 2005;62:671-673.

A Controlled Study of Cognitive Deficits in Children With Chronic Lyme Disease
AUTHORS: Tager FA, Fallon BA, Keilp J, Rissenberg M, Jones CR, Liebowitz MR.
SOURCE: J Neuropsychiatry Clin Neurosci 13:500-507, November 2001
FULL TEXT: http://www.lymediseaseassociation.org/Tager.pdf

Delirium and Lyme disease.
AUTHORS: Caliendo MV, Kushon DJ, Helz JW.
SOURCE: Psychosomatics. 1995 Jan-Feb;36(1):69-74.

Differential Diagnosis and Treatment of Lyme Disease with Special Reference to Psychiatric Practice.
AUTHORS: Nields JA, Fallon BA.
SOURCE: Directions in Psychiatry, 1998, 18: 209-228.

Endogenous paranoid-hallucinatory syndrome caused by Borrelia encephalitis
AUTHORS: Barnett W, Sigmund D, Roelcke U, Mundt C.
SOURCE: Nervenarzt 1991 Jul;62(7):445-7 [German]

Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States, 1988.
AUTHORS: Eng TR, Harkess JR, Fishbein DB, Dawson JE, Greene CN, Redus MA, Satalowich FT.
SOURCE: JAMA 1990 Nov 7;264(17):2251-8

Failure of tetracycline therapy in early Lyme disease.
AUTHORS: Dattwyler RJ, Halperin JJ.
SOURCE: Arthritis Rheum. 1987 Apr;30(4):448-50.

Functional Brain Imaging and Neuropsychological Testing in Lyme Disease
AUTHORS: Fallon BA, Das S, Plutchok JJ, Tager F, Liegner K, Van Heertum R.
SOURCE: CID 1997; 25:S57-63
COMPLETE ARTICLE AT:
http://www.journals.uchicago.edu/doi/pdf/10.1086/516175

Geographic correlation of schizophrenia to ticks and tick-borne encephalitis.
AUTHORS: Brown JS Jr.
SOURCE: Schizophr Bull 1994;20(4):755-75

Geographic distribution of Lyme disease in Mudanjiang
AUTHORS: Zhang Z.
SOURCE: Zhonghua Liu Xing Bing Xue Za Zhi. 1991 Jun;12(3):154-7. [Chinese]

Higher Prevalence of Antibodies to Borrelia Burgdorferi in Psychiatric Patients Than in Healthy Subjects
AUTHORS: Hajek T, Paskova B, Janovska D, Bahbouh R, Hajek P, Libiger J, Hoschl C.
SOURCE: Am J Psychiatry 159:297-301, February 2002
COMPLETE TEXT AT:
http://ajp.psychiatryonline.org/cgi/reprint/159/2/297

Human babesiosis--an unrecorded reality.
AUTHOR: Sherr VT
SOURCE: Med Hypotheses. 2004;63(4):609-15

Late-Stage Neuropsychiatric Lyme Borreliosis: Differential Diagnosis and Treatment
AUTHORS: Fallon BA, Schwartzberg M, Bransfield R, Zimmerman B, Scotti A, Weber CA, Liebowitz MR.
SOURCE: Psychosomatics 1995;36:295-300
COMPLETE TEXT AT:
http://www.wadhurst.demon.co.uk/lyme/lyme101.htm

Long-term cognitive effects of Lyme disease in children.
AUTHORS: Adams WV, Rose CD, Eppes SC, Klein JD.
SOURCE: Appl Neuropsychol 1999;6(1):39-45

Loss of the sense of humor
AUTHORS: Ramanan SV.
SOURCE: Arch Intern Med 2000 Sep 11;160(16):2546

Lyme borreliosis in neurology and psychiatry
AUTHORS: Kohler J.
SOURCE: Fortschr Med. 1990 Apr 10;108(10):191-3, 197. Review. [German]

Lyme disease--neuroborreliosis
AUTHORS: Jovanovic J, Cvjetkovic D, Vukadinov J.
SOURCE: Med Pregl. 1995;48(3-4):120-2. [Serbo-Croatian: Roman]

Lyme Disease: A Neuropsychiatric Illness
AUTHORS: Fallon BA, Nields JA.
SOURCE: Am J Psychiatry 1994 Nov;151(11):1571-83
COMPLETE TEXT AT:
http://www.angelfire.com/biz/romarkaraoke/lymeart.html

Lyme encephalopathy.
AUTHORS: Sanders K, Rogers JD.
SOURCE: Neurology. 1991 Jun;41(6):952-3.

Lyme encephalopathy: long-term neuropsychological deficits years after acute neuroborreliosis.
AUTHORS: Benke T, Gasse T, Hittmair-Delazer M, Schmutzhard E.
SOURCE: Acta Neurol Scand. 1995 May;91(5):353-7.

Lyme neuroborreliosis manifesting as an intracranial mass lesion.
AUTHORS: Murray R, Morawetz R, Kepes J, el Gammal T, LeDoux M.
SOURCE: Neurosurgery. 1992 May;30(5):769-73.

Lyme neuroborreliosis of mental manifestation. Apropos of a case
AUTHORS: Gueglio B, Raffi F, Marjolet M.
SOURCE: Rev Med Interne. 1996;17(7):599. [French]

Lyme neuroborreliosis revealed as a normal pressure hydrocephalus: a cause of reversible dementia.
AUTHORS: Etienne M, Carvalho P, Fauchais AL, Pestel-Caron M, Doucet J, Chassagne P.
SOURCE: J Am Geriatr Soc. 2003 Apr;51(4):579-80.

Lyme Psychosis
AUTHORS: van den Bergen HA, Smith JP, van der Zwan A.
SOURCE: Ned Tijdschr Geneeskd 1993 Oct 9;137(41):2098-100 [Dutch]

Memory and executive functions in adolescents with posttreatment Lyme disease
AUTHORS: McAuliffe P, Brassard MR, Fallon B
SOURCE: Applied Neuropsychology, Volume 15, Issue 3 July 2008, pp. 208 - 219

Meningoradiculoencephalitis in Lyme disease. A case with major regressive mental disorders.
AUTHORS: Ferroir JP, Reignier A, Nicolle MH, Guillard A.
SOURCE: Presse Med. 1988 Apr 16;17(14):697. [French]

Mental disorders in the course of lyme borreliosis and tick borne encephalitis
AUTHORS: Juchnowicz D, Rudnik I, Czernikiewicz A, Zajkowska J, Pancewicz SA.
SOURCE: Przegl Epidemiol 2002;56 Suppl 1:37-50 [Polish]

Mental disorders in the course of neuroborreliosis: own observation
AUTHORS: Zajkowska JM, Poplawska R, Pancewicz SA, Kondrusik M, Gudel I, Snarska I.
SOURCE: Psychiatr Pol 1999 Nov-Dec;33(6):939-46 [Polish]

Mental disorders in Lyme disease
AUTHORS: Rudnik-Szalaj I, Poplawska R, Zajkowska J, Szulc A, Pancewicz SA, Gudel I.
SOURCE: Pol Merkuriusz Lek. 2001 Nov;11(65):460-2. Review. [Polish]

Mental problems in Lyme disease
AUTHORS: Rudnik I, Poplawska R, Zajkowska J, Konarzewska B, Juchnowicz D, Pancewicz SA
SOURCE: Pol Merkuriusz Lek. 2003 Aug;15(86):161-4

Multiple neurologic manifestations of Borrelia burgdorferi infection
AUTHORS: Dupuis MJ.
SOURCE: Rev Neurol (Paris) 1988;144(12):765-75 [French]

Munchausen's syndrome by proxy and Lyme disease: medical misogyny or diagnostic mystery?
AUTHOR: Sherr VT.
SOURCE: Med Hypotheses. 2005;65(3):440-7.

Musical Hallucinations in Patients with Lyme Disease
AUTHORS: Stricker, Winger
SOURCE: Southern Medical Journal 2003; 96(7):711-715

Neuroborreliosis: a psychiatric problem?
AUTHORS: Poplawska R, Szulc A, Zajkowska J, Pancewicz S.
SOURCE: Psychiatr Pol 1999 Mar-Apr;33(2):241-50 [Polish]

Neurologic syndromes in Lyme disease
AUTHORS: Zajkowska JM, Hermanowska-Szpakowicz T, Kondrusik M, Pancewicz SA
SOURCE: Pol Merkuriusz Lek. 2000 Aug;9(50):584-8. Review. [Polish]

Neurological and psychological symptoms after the severe acute neuroborreliosis.
AUTHORS: Gustaw K, Beltowska K, Studzinska MM.
SOURCE: Ann Agric Environ Med 2001;8(1):91-4
COMPLETE TEXT AT:
http://www.aaem.pl/pdf/aaem0113.htm

Neuropsychiatric Lyme Disease: the New 'Great Imitator'
AUTHOR: Fallon B
SOURCE: Psychiatric Times, June 2004

The neuropsychiatric manifestations of Lyme borreliosis
AUTHORS: Fallon BA, Nields JA, Burrascano JJ, Liegner K, DelBene D, Liebowitz MR.
SOURCE: Psychiatr Q 1992 Spring;63(1):95-117
COMPLETE TEXT AT:
http://www.lymenet.org

Neuropsychiatric Lyme Disease.
AUTHORS: Fallon BA.
SOURCE: Harvard Mental Health Letter, Forum 10/95

Neuropsychiatric manifestations of Lyme disease
AUTHORS: Paparone PW.
SOURCE: J Am Osteopath Assoc 1998 Jul;98(7):373-8

Neuropsychological functioning in chronic Lyme disease.
AUTHORS: Westervel HJ, McCaffrey RJ.
SOURCE: Neuropsychol Rev 2002 Sep;12(3):153-77 Review.

The organic disorders in the course of Lyme disease
AUTHORS: Rudnik I, Konarzewska B, Zajkowska J, Juchnowicz D, Markowski T, Pancewicz SA
SOURCE: Pol Merkuriusz Lek. 2004 Apr;16(94):328-31

Pain, fatigue, depression after borreliosis. Antibiotics used up--what next?
AUTHORS: Woessner R, Treib J
SOURCE: MMW Fortschr Med. 2003 Sep 18;145(38 ):45-8

Painful hallucinations and somatic delusions in a patient with the possible diagnosis of neuroborreliosis.
AUTHORS: Bar KJ, Jochum T, Hager F, Meissner W, Sauer H.
SOURCE: Clin J Pain. 2005 Jul-Aug;21(4):362-3.

Panic Attacks May Reveal Previously Unsuspected Chronic Disseminated Lyme Disease
AUTHORS: Sherr VT.
SOURCE: Journal of Psychiatric Practice, 6:352-356, November 2000

Parasitic delirium in patient with multiorganic pathology: a complex situation
AUTHORS: Hernandez-Albujar S, Rubio G, Gopar J, Galeote G, Rey R, Gil A.
SOURCE: An Med Interna 1996 Nov;13(11):549-51 [Spanish]

The Physician as a Patient: Lyme Disease, Ehrlichiosis, and Babesiosis
A Recounting of a Personal Experience with Tick-Borne Diseases
AUTHORS: Sherr VT.
SOURCE: Practical Gastroenterology, January 2000
COMPLETE TEXT AT:
http://www.ilads.org/sherr2.htm

Post-Lyme syndrome and chronic fatigue syndrome. Neuropsychiatric similarities and differences.
AUTHORS: Gaudino EA, Coyle PK, Krupp LB.
SOURCE: Arch Neurol 1997 Nov;54(11):1372-6

Prevalence of Borrelia burgdorferi serum antibodies in 651 patients with predominantly neurologic diseases
AUTHORS: Muller M, Retzl J, Plank E, Scholz H, Ziervogel H, Stanek G.
SOURCE: Wien Klin Wochenschr. 1993;105(21):599-602. [German]

Preventable cases of autism: relationship between chronic infectious diseases and neurological outcome.
AUTHOR: Bransfield, R.
SOURCE: Pediatric Health. April 2009, Vol. 3, No. 2, Pages 125-140.

Psychiatric aspects of Lyme disease in children and adolescents:
A community epidemiologic study in Westchester, New York (pdf)
AUTHORS: Fallon BA, Bird H, Hoven C, Cameron D, Liebowitz MR, Shaffer S.
SOURCE: JSTD 1994; 1:98-100

Psychiatric manifestations of Lyme borreliosis
AUTHORS: Fallon BA, Nields JA, Parsons B, Liebowitz MR, Klein DF.
SOURCE: J Clin Psychiatry 1993 Jul;54(7):263-8

Psychiatric presentations of non-HIV infectious diseases.
AUTHORS: Schneider RK, Robinson MJ, Levenson JL.
SOURCE: Psychiatr Clin North Am 2002 Mar;25(1):1-16

Psychologic disorders in acute and persistent neuroborreliosis
AUTHORS: Poplawska R, Konarzewska B, Gudel-Trochimowicz I, Szulc A.
SOURCE: Pol Merkuriusz Lek 2001 Jan;10(55):36-7 [Polish]

Psychological states and neuropsychological performances in chronic Lyme disease
AUTHORS: Elkins LE, Pollina DA, Scheffer SR, Krupp LB.
SOURCE: Appl Neuropsychol 1999;6(1):19-26

A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy
AUTHORS: Fallon BA, et. al.
SOURCE: Neurology, first published on October 10, 2007 as doi

Rapidly progressive frontal-type dementia associated with Lyme disease
AUTHORS: Waniek C, Prohovnik I, Kaufman MA, Dwork AJ.
SOURCE: J Neuropsychiatry Clin Neurosci 1995 Summer;7(3):345-7

Recurrent and relapsing course of borreliosis of the nervous system
AUTHORS: Omasits M, Seiser A, Brainin M.
SOURCE: Wien Klin Wochenschr. 1990 Jan 5;102(1):4-12. Review. [German]

Regional cerebral blood flow and cognitive deficits in chronic lyme disease.
AUTHORS: Fallon BA, Keilp J, Prohovnik I, Heertum RV, Mann JJ.
SOURCE: J Neuropsychiatry Clin Neurosci. 2003 Summer;15(3):326-32.

Repeated Antibiotic Therapy in Chronic Lyme Disease.
AUTHORS: Fallon BA, Weis N, Tager F, Fein L, Liegner K, Liebowitz MR.
SOURCE: Journal of Spirochetal and Tick Borne Diseases, 1999; 6: 1-9.

Reversible cerebral hypoperfusion in Lyme encephalopathy
AUTHORS: Logigian EL, Johnson KA, Kijewski MF, Kaplan RF, Becker JA, Jones KJ, Garada BM, Holman BL, Steere AC.
SOURCE: Neurology 1997 Dec;49(6):1661-70

Seasonal correlation of sporadic schizophrenia to Ixodes ticks and Lyme borreliosis
AUTHORS: Fritzsche M.
SOURCE: International Journal of Health Geographics 2002 1:2
COMPLETE TEXT AT:
http://www.pubmedcentral.nih.gov/articl ... d=12453316

Sleep quality in Lyme disease.
AUTHORS: Greenberg HE, Ney G, Scharf SM, Ravdin L, Hilton E.
SOURCE: Sleep. 1995 Dec;18(10):912-6.

Tc-99m HMPAO Brain SPECT Imaging in Chronic Lyme Disease.
AUTHORS: Plutchok, Tikofsky, Liegner, Kochevar, Fallon, Van Heertum.
SOURCE: JSTD Vol. 6, No. 3, 1999. pp. 117-122.

Tullio phenomenon and seronegative Lyme borreliosis [letter]
AUTHORS: Nields JA, Kueton JF.
SOURCE: Lancet 1991 Jul 13;338(8759):128-9

A 25-year-old woman with hallucinations, hypersexuality, nightmares, and a rash.
AUTHORS: Stein SL, Solvason HB, Biggart E, Spiegel D.
SOURCE: Am J Psychiatry. 1996 Apr;153(4):545-51.

The Underdiagnosis of Neuropsychiatric Lyme Disease in Children and Adults
AUTHORS: Fallon BA, Kochevar JM, Gaito A, Nields JA.
SOURCE: Psychiatric Clinics of North America, 1998; 21: 693-703
COMPLETE TEXT AT:
http://www.lymenet.org

Untreated neuroborreliosis: Bannwarth's syndrome evolving into acute schizophrenia-like psychosis. A case report.
AUTHORS: Roelcke U, Barnett W, Wilder-Smith E, Sigmund D, Hacke W.
SOURCE: J Neurol 1992 Mar;239(3):129-31

WAIS-III and WMS-III performance in chronic Lyme disease.
AUTHORS: Keilp JG, Corbera K, Slavov I, Taylor MJ, Sackeim HA, Fallon BA.
SOURCE: J Int Neuropsychol Soc. 2006 Jan;12(1):119-29

Neuropsychiatric Lyme Disease Online Resources:
http://www.lymeinfo.net/neuropsych.html

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NEURO-COGNITIVE LYME DISEASE

http://www.lymeinfo.net/neuropsych.html

Lyme disease patients can experience symptoms such attention problems, short-term memory loss, depression, panic attacks, personality changes, mood swings, and/or learning disabilities. Literature on these manifestations is found below.
LymeInfo's Recommendations:

Distinct pattern of cognitive impairment noted in study of Lyme patients
by Marian Rissenberg, Ph.D. & Susan Chambers, M.D.
The Lyme Times, Vol. 20, January-March 1998, pp. 29 -32
SUMMARY: The following items are covered: Cognitive Characteristics of Chronic Lyme Encephalopathy, Neuropsychological deficits, Possible Pathophysiologic Mechanisms of Cognitive Impairment in Lyme Disease, Clinical Impressions and Implications for Diagnosis and Treatment in Chronic Lyme Disease, Cognitive impairment in Lyme disease: specific functions and the impact or deficits.

Shadowland of the Mind
by Pamela Weintraub
SUMMARY: Shadowland is part one of a series on Neurological Lyme Disease. The series addresses issues of patients being stigmatized with psychiatric labels. Also see Part Two, Part Three, and An Infection Can Change Your Personality.

Brochure: What Psychiatrists Should Know About Lyme Disease (pdf file)
/ by ILADS
SUMMARY: This printable brochure outlines information that psychiatrists need to be aware of, such as when to suspect Lyme disease and how to treat it.

The Role of Neuropsychological Testing in Children with Lyme Disease (pdf file)
by Leo Shea, Ph.D. and Judith Leventhal, Ph.D.
SUMMARY: Provides a comprehensive review of neuropsych testing and its benefits for Lyme patients, particularly children.

The Neuropsychiatric Assessment of Lyme Disease
by Robert Bransfield, M.D.
SUMMARY: "From a combination of clinical experience, journal review, and discussion with colleagues, a structured interview was developed" to assist in the overall clinical assessment when late state Lyme disease is suspected. Additional material is available at the same website. SEE: Mental Health and Illness .Com

Featured Research on Lyme Encephalopathy
Columbia University Lyme Website
SUMMARY: A commentary on the study "A Randomized, Placebo-Controlled Trial of Repeated IV Antibiotic Therapy for Lyme Encephalopathy," which was published in the journal Neurology in March 2008.

Bibliography of Neuropsychiatric Lyme
A collection of references to medical/scientific literature on psychiatry and Lyme/tick-borne disease. One item worth obtaining the full-text of is "The Neuropsychiatric Manifestations of Lyme Borreliosis".

Full Text Peer-Reviewed Articles

The following articles, listed alphabetically, are available online at no charge. Additional peer-reviewed articles are listed in the bibliography above, and some of those may be worth obtaining through your medical library.

A Controlled Study of Cognitive Deficits in Children With Chronic Lyme Disease (pdf file)
Tager, Fallon, et. al.
J Neuropsychiatry Clin Neurosci 13:500-507, November 2001

Carbamazepine in the Treatment of Lyme Disease Induced Hyperacusis
Nields, Fallon, Jastreboff
J Neuropsychiatry Clin Neurosci 11:97-99, February 1999

Functional Brain Imaging and Neuropsychological Testing in Lyme Disease (pdf file)
by Fallon, Das, Plutchok, Tager, Liegner, Van Heertum
CID 1997; 25:S57-63
(Requires Adobe Acrobat)

Higher Prevalence of Antibodies to Borrelia Burgdorferi in Psychiatric Patients Than in Healthy Subjects
by Hajek, et. el.
Am J Psychiatry 159:297-301, February 2002

Late-Stage Neuropsychiatric Lyme Borreliosis: Differential Diagnosis and Treatment
by Fallon, et. al.
Psychosomatics 1995;36:295-300

Lyme Disease: A Neuropsychiatric Illness
by Fallon, Nields
Am J Psychiatry 151:11, November 1994 pp.1571-1580

Musical Hallucinations in Patients with Lyme Disease
by Stricker, Winger
Southern Medical Journal 2003; 96(7):711-715

The Neuropsychiatric Manifestations of Lyme borreliosis
by Fallon, Nields, Burrascano, Liegner, DelBene, Liebowitz
Psychiatr Q 1992 Spring;63(1):95-117
**RECOMMENDED ITEM

The Physician as a Patient: Lyme Disease, Ehrlichiosis, and Babesiosis: A Recounting of a Personal Experience with Tick-Borne Diseases
by Sherr
Practical Gastroenterology, January 2000

Potential uses of Modafinil in Psychiatric Disorders (pdf file)
by Bransfield
Journal of Applied Research, 2004 Spring; 4(2): 198-208
(Requires Adobe Acrobat)
For insurance, see: Forms 1 and Forms 2

Regional Cerebral Blood Flow and Cognitive Deficits in Chronic Lyme Disease
by Fallon, et. al.
J Neuropsychiatry Clin Neurosci 15:326-332, August 2003

Seasonal Correlation of Sporadic Schizophrenia to Ixodes Ticks and Lyme Borreliosis
by Fritzsche
International Journal of Health Geographics 2002 1:2

The Underdiagnosis of Neuropsychiatric Lyme Disease in Children and Adults
by Fallon, Kochevar, Gaito, Nields
Psychiatric Clinics of North America, 1998; 21: 693-703

Misc. Articles (News, Newsletters, Websites, etc.)

Articles By Robert Bransfield, M.D.
Lyme Alliance Newsletter
The following articles are available: "All in Your Head?", "Microbes and Mental Illness", "Spirochetes On the Brain", "Lyme Disease and Cognitive Impairments", "Lyme, Depression, and Suicide", "Agression and Lyme Disease", "A Tale of Two Spirochetes" and "Sex and Lyme Disease". The following are the most recently added: "Gettysburg Times Article", "The Klempner Study", "Posttraumatic Stress Disorder and Infectious Encephalopathies", "The Psychotropic Management of Late-Stage Lyme and Associated Diseases" and "What Causes Illness and Mental Illness?"

Articles by Leo J. Shea III, Ph.D. and Judith G. Leventhal, Ph.D.
Neuropsychological Evaluation & Treatment Services, P.C.
The following articles are available: "The Role of Neuropsychology in children with Lyme Disease," "Neuropsychological Testing: It's Role in Lyme Disease," "Brain Injury and Lyme Disease: Top Ten Reasons to Think Spirochete," and "Protecting Your Family From Lyme Disease."

Articles by Virginia Sherr, M.D.
The Human Side of Lyme
Articles Include: "Lyme is a Brain Disease," "Panic Attacks and Lyme," as well as many essays on Lyme symptoms, coinfections, and case histories.

Lyme Disease, Comorbid Tick-Borne Diseases, and Neuropsychiatric Disorders
Robert C. Bransfield, MD. Psychiatric Times December 1, 2007
"Knowingly or not, most psychiatrists have at some point been perplexed by patients with late-stage psychiatric manifestations of Lyme borreliosis."

Do Bartonella Infections Cause Agitation, Panic Disorder, and Treatment-Resistant Depression?
Medscape, Sept. 2007

Understanding the Puzzle of Chronic Lyme
Columbia University Medical Center News, August 2004

Coughs and Sneezes Spread Mind Diseases
New Scientist, November 2004

Two Opposing Camps Offer Insight Into Treatment of Neurologic Lyme Disease
Applied Neurology, September 2006
Also see Perceptions

Brain Scans Distinguish Lyme Disease From Primary Psychiatric Disorders
Doctor's Guide to the Internet, October 24, 1997

Can Lyme Disease Cause Psychiatric Disorders?
by Joan Arehart-Treichel
Psychiatric News: March 15, 2002

A Feeling for the Organism (pdf)
by Pamela Weintraub
Lyme Times: Winter 2001/Spring 2002, p. 5-14

Teen Angst or Depression?
Seattle Post-Intelligencer: October 2002

Naturopathic perspective on the assessment and treatment of Lyme-associated autism
by Nicola McFadzean
Townsend Letter for Doctors and Patients: April, 2007

Neurological Impairment Seen in Patients Given Lymerix
DG News: October, 2002

I Refused to Give Up on My Daughter
Good Housekeeping: October 2003
Free Registration Required

Cognition Problems Fuel Lyme Disease Debate
by Nancy Walsh
Clinical Psychiatry News: October 2002
Free Registration Required

Lyme disease victims find new hope in study on Cape
Cape Cod Times: November 2002
Free Registration Required

Amy Tan, Ticked Off About Lyme
Washington Post, August 2003

A Disease in Disguise
Newsweek: August, 2004

Diseases of the Mind
Newsweek International: December 2003

Brain Imaging
Columbia University Lyme Website

Treatment of Lyme Disease
Columbia University Lyme Website

Lyme Disease and Psychiatric Disorders
P&S Journal: Winter 1998, Vol.18, No.1

Presentations

Psychiatric and neuropsychological aspects of Lyme Disease
by Felice A. Tager, Ph.D. and Brian A. Fallon, M.D.
Meeting of the American Psychiatric Association, May 2002

Testimonies of Brian Fallon, M.D. and Carolyn Britton, M.D.
NY Assembly Health Committee Hearing on Lyme Disease
November, 2001 (Scroll down)

Testimony of Robert Bransfield, M.D.
NY Assembly Health Committee Hearing on Lyme Disease
November, 2001

Spirochetes may "love the brain to death"
by Dr. Diego Cadavid
101st General Meeting of the American Society for Microbiology, May, 2001.

Neurologic Lyme Disease: Defining and Treating an Elusive Target (Expired Link)
by Brian A. Fallon, M.D., and Harry Goldhagen, MS
14th International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, April, 2001.

Review of Lyme Neuroborreliosis (Expired Link)
13th International Scientific Conference on Lyme Disease and other Tick-borne Disorders, March, 2000.

Lyme Neuroborreliosis: Recognition, Treatment, and Retreatment of Relapse (Expired Link)
13th International Scientific Conference on Lyme Disease and other Tick-borne Disorders, March, 2000.

Cognitive Remediation
by Leo Shea, PhD
12th International Conference on Lyme Disease and Other Spirochetal and Tick-Borne Disorders, April 1999.
Also See: presentation abstract

Summary of Neurologic Lyme Disease Presentations
by Brain A. Fallon, M.D.
12th International Conference on Lyme Disease and Other Spirochetal and Tick-Borne Disorders, April 1999.

Lyme Disease vs. Somatoform Disorders
by Brian A. Fallon, M.D.
10th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, April 1997.

Psychiatric Aspects of LD & the Use of SPECT Imaging
by Brian A. Fallon, M.D.
10th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, April 1997.

Seronegative Chronic Meningoencephalomyelitis in LD
by Kenneth B. Liegner, M.D.
10th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, April, 1997.

Lyme Disease and the Clinical Spectrum of Antibiotic-Responsive Chronic Meningoencephalomyelitides
by Kenneth B. Liegner, M.D.
9th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, April, 1996.

Lyme Disease vs. Depression vs. Somatization: Cognitive Tests & Functional Imaging
by Brian A. Fallon, M.D.
9th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, April 1996

Neurofeedback and Lyme Disease: A Clinical Application of the Five Phase Model of CNS Functional Transformation
by Valdeane Brown, Ph.D.
Annual Conference of the Society for the Study of Neuronal Regulation, May 1995

Books & Videos:

The Lyme-Autism Connection: Unveiling the Shocking Link
By Tami Duncan, Bryan Rosner, Robert Bransfield
"When one looks beneath the surface of these seemingly diverse disorders, the underlying discoveries are shocking. Awaiting your discovery is the Lyme-Autism connection."

Bipolar Odyssey
By David Moyer, CSW, Lt Col
Too Good to be True? Nutrients Quiet the Unquiet Brain - A Four Generation Bipolar Odyssey

Neuropsychiatric Aspects of Other Infectious Diseases.
By Brian A. Fallon, M.D.
Comprehensive Textbook of Psychiatry., Ed. Kaplan and Sadock. Williams & Wilkins, 2002.

Lyme Disease Association Conference Videos
Various presentations are available by a number of psychiatrists with expertise in Lyme.

Columbia Lyme Interviews
by Brian A. Fallon, M.D.
Columbia University Lyme Website

Additional Resources:

The Human Side of Lyme
Dr. Virginia Sherr's website on neuroborreliosis.

Lyme Research in Adolescents
Patrick McAuliffe's Doctoral Dissertation

Lyme Induced Autism
Site created by parents of children with Lyme Disease and Autism who are struggling to find the proper care for their children. An Overview of the LIA Think Tank.

Medical Literature Summaries
In particular, the symptoms file has information pertaining to neuropsychiatric Lyme. The Neurologic system begins on page 17 of the symptoms file.

Journal Articles
A Selection of Free Journal Articles Available Online on the subject of Lyme and Other Tick-Borne Diseases.

Lyme slide show
SPECT perfusion images

The Whole Brain Atlas
SPECT Scans

Neurological Testing Procedures
Not Lyme-specific

Neuropsychological Testing
Not Lyme-specific

Neuropsychiatric Lyme Page
By Kay

Annotated Bibliographies
Art Doherty's "Annotated Bibliographies of Medical and Scientific Articles on Lyme Disease Issues".

Other Diseases/Conditions and Lyme Disease
by Art Doherty

Lyme Disease and Bipolar Disorder
by Art Doherty

Lyme Disease and Neurological Manifestations
by Art Doherty

Lyme Disease and Sleep Disorders
by Art Doherty

[soijuv]

Useiden psyykkisten sairauksien on todettu olevan yhteydessä poikkeavaan immuunipuolustuksen toimintaan. Tutkimuksessa asioiden välinen kausaalinen yhteys osoitetaan. Tutkimuksen mukaan aivojen mikroglia-solujen määrä ja toiminta on yhteydessä psyykkisiin sairauksiin. Tilanne pystyttiin hiirillä korjaamaan istuttamalla keskushermostoonn terveitä soluja. (2010)


Key to psychological disorder may lie in the immune system

Published online 27 May 2010 | Nature | doi:10.1038/news.2010.268

http://www.nature.com/news/2010/100527/ ... s=news_rss

A type of cell that is known to protect the brain against infection could be involved in a form of psychological disorder, a new study reveals. What's more, restoring normal populations of these cells by transplantation can cure abnormal behaviour in mice.

Microglia are highly branched immune cells that constantly move around and scavenge the brain for debris and pathogens. Researchers have now shown that a genetic defect that reduces the number of these cells causes excessive grooming in mice. The behaviour is similar to that observed in trichotillomania in humans ? an obsessive-compulsive spectrum disorder that compels people to pull out their hair. "No connection had ever been made between microglia and behaviour," says Mario Capecchi at the University of Utah in Salt Lake City, whose team published the findings today in Cell1.

Scientists had presumed that abnormal behaviour stems from impaired neural function or brain development, says Christopher Pittenger, who studies the neural basis of psychiatric conditions at Yale University in New Haven, Connecticut. "To find that it has to do with microglia is a big surprise," says Pittenger, who was not involved in the new study.
Behaviour transplants

Mutations in a gene that regulates the formation of blood cells causes mice to spend double the normal amount of time removing body hair, leading to bald spots and deep skin wounds2. The gene, called Hoxb8, comes from a family of genes that establish the body plan in the developing embryo and regulate the formation of organs and tissues.

Capecchi and his team found that Hoxb8 was expressed throughout the brain, but only in microglia. Moreover, animals with Hoxb8 mutations had fewer microglia than normal mice. The researchers pinpointed the origin of the microglia to bone marrow ? soft tissue found in bone. The gene was expressed in bone-marrow stem cells, which produce many different types of blood cell, including one that may become microglia in the brain.

The researchers found that most of the animals with Hoxb8 mutations that received transplants of healthy bone marrow stopped their excessive grooming within four months. Their hair started to fill in the empty patches and their wounds began to heal. By contrast, a fraction of normal mice that received transplanted bone marrow from Hoxb8 mutant animals began to groom more than usual and developed hairless patches.

"It's a paradigm-shifting idea that you can transplant a compulsion into a normal animal," says Frank Burton, a neurobiologist at the University of Minnesota, Twin Cities.
Routine or worry?

Many psychiatric conditions have been associated with abnormal immune responses, but this study is unique because it shows a direct causal link, Capecchi says. He speculates that altered microglia may cause excessive grooming through their effects on neural activity. But the study has not ruled out a role for other immune cells or blood vessels.

It's also questionable whether the mouse model replicates features of obsessive-compulsive disorder in humans. The researchers haven't performed the key experiments to show that the behaviour is related to anxiety, says Francis Lee of Weill Cornell Medical College in New York City whose team last month reported a different mouse model of obsessive-compulsive behaviour3. Capecchi's team should also test whether drug treatments for obsessive-compulsive disorder alleviate symptoms in their mouse model, he says.

Although it's not clear how a dysfunction in the immune system causes neural circuits to go awry in psychiatric disorders, the scientists provide a valuable model for exploring these questions, Pittenger says. "I don't think these mice have obsessive-compulsive disorder, but I think they're fascinating and important and might ultimately shed some light on the disorder or other conditions," he says.

*
References
1. Chen, S.-K. et al. Cell 141, 775-785 (2010).
2. Greer, J. M. & Capecchi, M. R. Neuron 33, 23-34 (2002).
3. Shmelkov, S. V. et al. Nature Med. 16, 598-602 (2010).

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Lääkärit V. T. Sherr ja D. J. Solomon ovat kirjoittaneet artikkelin "Milloin psykiatrin tulisi epäillä borrelioosia". Useat borrelioosiin sairastuneet saavat jossakin vaiheessa sairauttaan lähetteen psykiatrin vastaanotolle. Seuraava artikkeli saattaisi olla hyödyllistä ottaa mukaan ja antaa psykiatrille luettavaksi.


When Should a Psychiatrist Suspect

Lyme Disease?

In a published study (Hajek et al, Am J Psychiatry

2002;159:297-301)



One-third of psychiatric inpatients showed signs of past infection with the Lyme spirochete, Borrelia burgdorferi. The International Lyme and Associated Diseases Society (ILADS) has found that even severe neuropsychiatric behavioral symptoms in this population can often be reversed or ameliorated when antibiotics are used along with the
indicated psychiatric treatments.

Don?t miss this crucial diagnosis.

Patients with late-stage Lyme disease may present with a variety of neurological and psychiatric problems, ranging from mild to severe. These include:

? Cognitive losses including:

o Memory impairment or loss ("brain fog")

o Dyslexia and word-finding problems

o Visual/spatial processing impairment (trouble finding things, getting lost)

o Slowed processing of information

? Psychosis

? Seizures

? Violent behavior, irritability

? Rage attacks/impulse dyscontrol

? Anxiety

? Depression

? Panic attacks

? Rapid mood swings that may mimic bipolarity (mania/depression)

? Obsessive compulsive disorder (OCD)

? Sleep Disorders

? Attention deficit/hyperactivity disorder (ADD/ADHD)-like syndrome

? Autism-like syndrome


Lyme disease is one of the fastest growing infectious diseases in the nation. The Centers for Disease Control and Prevention (CDC) reported over 23,783 new cases in 2002, and the government agency estimates that the total number may be tenfold higher. The disease is caused by the bite of a deer tick infected with the Borrelia burgdorferi (Bb) spirochete and may be complicated by other parasites or co-infections. It is hard to diagnose because fewer than half of all Lyme patients recall a tick bite or develop the signature erythema migrans ("bullseye") rash. As a result, many patients go untreated and develop psychiatric and/or neurological symptoms.

Lyme disease sometimes begins as a flu-like illness accompanied by fever, headache, sore throat and joint pain. After infection, patients may develop cardiac or early neurologic problems including meningitis, encephalitis and cranial neuropathies. Look for eyelid droop, facial weakness, numbness or pain, shoulder droop, sensory distortions or any other focal neurological signs. There may be a history of neck pain and stiffness or muscle twitching.

Some patients may have arthritic symptoms in single or multiple joints. Most patients mention this to a psychiatrist only if directly asked.

At any time after a tick bite, patients may also exhibit cognitive symptoms such as memory and concentration impairments and word-finding difficulties, ADD/ ADHD-like symptoms, learning disabilities, OCD, crying spells, rages, depression/bipolar disorder, panic/anxiety disorders and psychoses - all may be caused or exacerbated by Lyme disease.

Disorders of the nervous system have been found in 15 ? 40% of late-stage (tertiary) Lyme patients (Caliendo et al, Psychosomatics 1995;36:69-74). When Lyme disease affects the brain, it is often referred to as Lyme neuroborreliosis or Lyme encephalopathy. Usually the patient is totally unaware of its presence. Neuroborreliosis can mimic virtually any type of encephalopathy or psychiatric disorder and is often compared to neurosyphilis. Both are caused by spirochetes, are multi-systemic, and can affect a patient neurologically, producing cognitive dysfunction and organic psychiatric illness. Such symptoms may be dormant, only surfacing years later.

Dr. Brian Fallon, director of the Lyme Disease Research Program at Columbia University and principal investigator of the NIH-funded study of brain imaging and persistent Lyme disease, cites five questions that imply warning signs of possible Lyme encephalopathy:

? Are there markers of non-psychiatric disease such as erythema migrans rash, arthralgias or arthritis, myalgias, severe headaches, sound or light sensitivity, paresthesias, diffuse fasciculations, cardiac conduction defects, word-finding problems, short-term memory loss, tremors, cranial neuropathies, and/or radicular or shooting pain?

? Is this psychiatric disorder atypical or unusual? For example, does a panic attack last longer than the expected 1/2 hour? Or is it a first ever panic attack at age 50?

? Is there poor or paradoxical response or excessive side effect sensitivity to medications that are expected to be helpful for particular psychiatric symptoms?

? Is this new-onset disease without psychological precipitants such as new stressors or secondary gain?

? Is there an absence of a personal history or family history of major psychiatric disturbances? Negative answers to these questions do not rule out the presence of Lyme disease. But a "yes" to most of the questions, especially in a patient with an out-of-doors lifestyle or a pet, demands further clinical assessment.

Dr. Fallon recommends Western blot serologic studies, lumbar puncture, neuropsychological testing, brain MRI and SPECT (single photon emission computerized tomography) scans. For more information, see www.columbia-lyme.org.

Other helpful tests may include PCR for Borrelia burgdorferi in blood, serum, cerebrospinal fluid (CSF) and urine, and/or Borrelia antigen testing in urine and CSF. Because blood tests at the top three general medical laboratories in the nation fail to detect 35% of Lyme antibodies, ILADS recommends use of laboratories that specialize in Lyme and other tick-borne illnesses.

Contact www.lymediseaseassociation.org for a listing of recommended labs.

Blood tests should not be used to rule out Lyme disease when there is a strong clinical presentation. Dr. Robert Bransfield, a psychiatrist who specializes in infectious causes of neuropsychiatric illness, has developed a structured clinical interview to assess seronegative patients. See www.mentalhealthandillness.com

What to Do?

Screen patients for Lyme symptoms, especially those with complicated or atypical presentations. Be suspicious of Lyme if a patient mentions cognitive changes, extreme fatigue, weight changes, headaches, fibromyalgia, a history of "mono," "spider bites," multiple sclerosis, explosive rages or sudden mood swings. To elicit data about cognitive problems ask broad questions such as, "How do you think your brain is functioning?" or "How many things can you handle at one time?"

Consider Lyme disease in children with behavioral changes, fatigue, school phobias, academic problems, learning disabilities, headaches, sore throats, GI complaints and/or migrating pains. In teens, Lyme disease may be complicated by drug abuse.

The Lyme spirochete is slow growing and can be difficult to treat, so be sure the patient is treated with appropriate antibiotics for at least two to four weeks beyond symptom resolution.

Most individuals with Lyme disease respond to antibiotics, but the treatment course is highly patientspecific.

ILADS has published evidence-based guidelines for the diagnosis and treatment of Lyme and associated tick-borne diseases (Expert Rev Anti-Infect Ther 2004;2(Suppl):S1-S13). For more information,
visit the ILADS website at www.ilads.org.

Some of the common symptoms of late-stage (tertiary)

Lyme disease and other tick-borne co-infections:

? Profound fatigue

? Chills, sweats and skin flushes

? Night sweats

? Migrating arthralgias

? Muscle pains/twitching

? Sleep disturbances

? Severe headaches

? Shifting neurologic pains

? Tremors, shakiness

? Numbness, tingling sensations, pain often shifting and unusual in type

? Cranial nerve disturbance (Facial numbness, pain, tingling, paralysis, optic neuritis, trouble swallowing, distortion of smell or taste) See Category below.

The more severe neurological symptoms or disorders associated with late-stage Lyme disease:

? Progressive dementias

? Seizure disorders

? Strokes

? ALS-like syndrome (similar to Lou Gehrig?s Disease)

? Guillain-Barre-like syndrome

? Multiple sclerosis-like syndrome

? Parkinson?s disease-like syndrome

? Other extrapyramidal disorders

? Visual disturbances or loss

Checklist of common cognitive impairments in Lyme disease (from Marian Rissenberg, Ph.D., clinical neuropsychologist)

Losses in fields of attention/executive functions such as inability to maintain divided or sustained attention, auditory and mental tracking and scanning, and memory retrieval can affect:

? Memory functions (lost items, missed appointments, retold stories)

? Language functions (halting speech, disrupted participation in conversation)

? Visual/Spatial Processing (Inability to find things, tendency to get lost, disorganization, difficulty reading, especially for enjoyment)

? Abstract reasoning (Poor problem-solving/decision-making)

? Slowed processing speed (Familiar tasks take longer, can?t follow conversations well).

Most or all of these impairments, if caused by neuroborreliosis, may improve with proper antibiotics combined with other appropriate symptomatic treatments.

Disclaimer

The foregoing information is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If an individual suspects the presence of a tick-borne illness, that individual should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases.

Edited by

Drs. Virginia T. Sherr and Debra J. Solomon,

Psychiatrists
------------------------------------------------------------------------------
Artikkelissa pohditaan mikrobien osuutta erilaisten psyykkisten oireiden kuten masennus, kaksisuuntainen mielialahäiriö, skitsofrenia jne. aiheuttajana.

Mental Disorders: Infectious Diseases?

Alan J. Fridlund, Ph.D.

June, 2007

Recent advances in medications for many mental disorders ? especially depression and bipolar disorder, anxiety disorders, and schizophrenia -- have seduced us into a thinly veiled rehash of Hippocrates? famous ?humoral? theory of disease (p. 9). As Hippocrates had it, the major mental disorders stemmed from imbalances in, to quote Dr. Strangelove, ?vital bodily fluids.? Only today, Hippocrates? ?humors? aren?t fictive substances like black and yellow bile, but lab-certified neurotransmitters. Like a car whose engine knocks when it runs low on oil or chokes when it gets too much gas, so do our minds malfunction when we have too little of one transmitter, or too much of another. The function of psychotropic medication? To tweak our neurochemistry, raising the level of serotonin here, lowering dopamine there, until our mental engines come back in tune.

To be sure, this humoral theory in disguise is a tremendous pragmatic advance. For example, researchers took the first marketed Selective Serotonin Reuptake Inhibitor (SSRI) molecule, fluoxetine (Prozac), and jiggered it, for two main reasons: (1) to avoid infringing Eli Lilly?s then-lucrative patent on it (it?s now available in cheap but effective generic knockoffs), and (2) to formulate patentable and profitable competitive medications, ideally with as much efficacy but fewer side effects. One result was citalopram (Celexa), followed by its newer cousin escitalopram (Lexapro). Lexapro is now the best-selling SSRI, and for many patients it provides all of Prozac?s anti-depressant and anti-anxiety effects, but with weaker SSRI-type side effects (e.g., insomnia, nausea, sexual dysfunction).

A triumph for the ?serotonin? model of major depression, right? Well, yes and no. The SSRI?s do increase serotonin in certain areas of the brain, and they do ameliorate depression and anxiety, but the connection isn?t direct (to be trite, correlation doesn?t prove causation!). All we have to show is one counterexample, and that medication is known as tianeptine (Stablon), which is marketed in Europe but not the U.S. It is an antidepressant, just as effective as SSRI?s, but it?s not an SSRI at all. It?s the opposite, a Selective Serotonin Reuptake Facilitator (Preskorn, 2004). It reduces serotonin in the brain! The history of psychopharmacology is full of this kind of discovery: new medications with novel actions force researchers to change and even reverse their pet theories.

The humoral theory isn?t the only resurrection afoot in our understanding of mental disorders. Another one gathering steam harkens back to the late 19th century, and it holds that many mental disorders may result from infection. Of course, the genesis-story of ?biological theories? of psychopathology was of syphilis and its ugly attack on the brain, neurosyphilis or general paresis. People with general paresis often developed its symptoms 15-20 years after they were initially infected with syphilis, meaning that any ?smoking gun? of disease causation had cooled long before. For all practical purposes, these patients? hallucinations and delusions, moodiness and irritability, impaired reflexes and judgments, all led it to be considered a mental disorder. It was far from resembling any known sexually transmitted disease.

The story of the successive discoveries in general paresis is well-known (see p. 15). Krafft-Ebing, perhaps better known as Europe?s ?go-to? man on the psychiatry of ?sexual perversions? (he had authored the celebrated Psychopathia Sexualis in 1886), discovered in 1897 that inoculation of general paresis patients with infected flesh from obvious syphilis sufferers produced no new syphilis infection. This indicated that they had already been infected. And in a feat of both unbridled chutzpah and uncommon luck, Julius Wagner-Jauregg was able to cure general paresis, by giving its sufferers another disease, malaria. The tortuously high malarial fever baked and killed the syphilis spirochetes, leaving the patients to recover only from their malaria ? which, thanks to quinine, was usually brought under control. Wagner-Jauregg tried to treat other mental disorders with such ?fever therapy.? Tuberculosis extract failed, and no other mental disorder proved vulnerable to any fever. But conquering general paresis was triumph enough: Wagner-Jauregg won the Nobel Prize for it in 1927.

It has been nearly a century since this coup, and there has yet been no similarly convincing infectious-disease model of any other kind of psychopathology. But findings are accumulating that our future theories about psychopathology may well include words like pathogens, infection and inflammation. These findings apply to many key mental disorders. To list a few:

Obsessive-Compulsive Disorder

This disorder, with its overwhelming, ego-alien obsessions and compulsions, often occurs in young people, and is diagnosable in up to 2% of school-age children. Like its adult version, childhood OCD is thought to affect the basal ganglia, subcortical structures involved in smooth movements as well as smooth transitions in thinking. In OCD, many researchers say, malfunctioning basal ganglia lead to a pronounced tendency to go into ?brain-lock.? The sufferer gets stuck on thoughts or impulses, and can?t let go of them.

Also like its adult version, OCD in kids doesn?t appear out of the blue. The signs and symptoms worsen until the parents? concern leads first to a pediatrician?s visit, then a referral to a clinical psychologist or child psychiatrist, and finally to a diagnosis. But in a select group of children with OCD, perhaps up to one third, the onset of OCD is abrupt, and follows a bout of ordinary strep throat, or acute rheumatic fever from strep infection. Susan Swedo, a psychiatrist at the National Institutes of Mental Health, related one such story, of a ?12-year-old girl who went to bed perfectly healthy and literally couldn't get down the steps the next morning because of her repeating rituals" (in Knowlton, 1998).

Technically, the culprits in strep throat, acute rheumatic fever, and this abrupt-onset OCD are known as GABHS (group A beta-hemolytic streptococcal) bacteria. Partly to give her pediatric patients a cute and fuzzy name to describe what they had, Swedo named this OCD syndrome PANDAS, for Pediatric Autoimmune Neuropsychiatric Disease Associated with Streptococcal infection.

How would these bugs lead to sudden OCD symptoms? The prevailing view is that they represent an auto-immune response -- the child?s immune system tries to generate antibodies to vanquish the bacteria, but the antibodies misfire and damage basal ganglia cells instead (indeed, the strep bugs may have developed this molecular mimicry precisely to cause such mischief). This isn?t such a farfetched notion. Rheumatic fever, after all, is when our strep antibodies misfire and attack our heart valves.

The issue arises whether the more typical cases of childhood OCD, or adult-onset OCD, might represent such an auto-immune process. As yet, the evidence suggests that PANDAS is but one subtype of OCD-spectrum disorder, one largely confined to children, but the findings have opened researcher?s eyes to an intriguing way that pathogens may be involved in mental disorders (see Mell, Davis & Owens, 2005).

[soijuv]

Tutkijat järkyttyivät huomatessaan antibioottien auttavan skitsofrenian oireissa
Israelissa, Pakistanissa ja Brasiliassa tehdyissä tutkimuksissa antibioottihoidolla saavutettiin merkittävä hyöty skitsofrenian hoidossa. Nyt tätä halpaa, yleisesti teini-ikäisten aknen hoitoon käytettyä, antibioottia, tutkitaan myös Britanniassa. Tulehdus saattaa selittää myös, ainakin osan, psykooseista ja Alzheimerin taudeista. (2012)

http://www.independent.co.uk/news/scien ... 69121.html

Scientists shocked to find antibiotics alleviate symptoms of schizophrenia

Chance discovery of link between acne drug and psychosis may unlock secrets of mental illness

Jeremy Laurance
Friday 02 March 2012

A cheap antibiotic normally prescribed to teenagers for acne is to be tested as a treatment to alleviate the symptoms of psychosis in patients with schizophrenia, in a trial that could advance scientific understanding of the causes of mental illness.


The National Institute for Health Research is funding a £1.9m trial of minocycline, which will begin recruiting patients in the UK next month. The research follows case reports from Japan in which the drug was prescribed to patients with schizophrenia who had infections and led to dramatic improvements in their psychotic symptoms.

The chance observation caused researchers to test the drug in patients with schizophrenia around the world. Trials in Israel, Pakistan and Brazil have shown significant improvement in patients treated with the drug.

Scientists believe that schizophrenia and other mental illnesses including depression and Alzheimer's disease may result from inflammatory processes in the brain. Minocycline has anti-inflammatory and neuroprotective effects which they believe could account for the positive findings.

Details of the trial were presented to the independent Schizophrenia Commission by Bill Deakin, professor of psychiatry at the University of Manchester, who is the lead investigator. The 12-member commission, set up by the mental health charity Rethink, is looking into the treatment and care of people with schizophrenia, and is due to report in the summer.

The first account of minocycline's effects appeared in 2007 when a 23-year-old Japanese man was admitted to hospital suffering from persecutory delusions and paranoid ideas. He had no previous psychiatric history but became agitated and suffered auditory hallucinations, anxiety and insomnia.

Blood tests and brain scans showed no abnormality and he was started on the powerful anti-psychotic drug halperidol. The treatment had no effect and he was still suffering from psychotic symptoms a week later when he developed severe pneumonia.

He was prescribed minocycline to treat the pneumonia and within two weeks the infection was cleared and the psychosis resolved. Minocycline was stopped and his psychiatric symptoms worsened. Treatment with the drug was resumed and within three days he was better again. Halperidol was reduced but he remained on minocycline. Two years after his psychotic episode, he was still well.

The UK trial aims to recruit 175 patients recently diagnosed with schizophrenia, half of whom will be randomly allocated to take minocycline with their standard anti-psychotic treatment while the remainder take a placebo.

Brain scans will be carried out at the start and end of the 12 month trial to compare loss of grey matter ? an effect of schizophrenia ? in the two groups. Tests will also measure inflammatory markers in the blood.

Professor Sir Robin Murray, chair of the Schizophrenia Commission said: "Infection or inflammation might be involved in a minority of people with acute psychosis and minocycline might counter this. In depression inflammatory markers go up and in Alzheimer's too."

Jeremy Laurance is a member of the Schizophrenia Commission

[soijuv]

Borrelioosielokuva "Under Our Skinin" - sivuilla on artikkeli jossa käsitellään borrelia-bakteerin yhteyttä psyykkisiin oireisiin esim. agressiiviseen käyttäytymiseen. He tapasivat filmin teon aikana useita sairastuneita sekä lääkäreitä jotka olivat henkilökohtaisesti tai työssään kohdanneet potilaita joilla esiintyi bakteerin aiheuttamia "äkillisiä vihanpurkauksia (Lyme rage)". Aiheesta on myös useita tieteellisiä julkaisuja.
Amerikkalaisen IDSAn yksi lääkäri, Gary Wormser, kieltää mahdollisuuden että borreliabakteeri voisi aiheuttaa psykoosia, agressiivista käytöstä tm neuropsykiatrisia oireita. Hän kieltää mediassa toistuvasti bakteerin aiheuttavan minkäänlaisia kroonisia ongelmia sairastuneille.

http://www.underourskin.com/news/scient ... -lyme-rage

Scientific evidence for "Lyme Rage"

In light of the tragic shooting in Illinois, we’d like weigh in on the issue of whether the shooter’s case of late-stage Lyme disease could have caused violent behavior. First, during our four years of research for the film, UNDER OUR SKIN, we interviewed a number of patients who had bouts of “Lyme Rage” before appropriate treatment. While it doesn’t seem that common, it does seem possible. In addition, many of the physicians we interviewed, specifically the ones who treat a large number of Lyme patients, acknowledge that they have had patients with Lyme Rage. And finally, there are over 100 peer-reviewed medical journal articles linking tick-borne diseases to mental symptoms and quite a few that reference Lyme-induced rages. For your convenience, I’ve cited some of these articles at the bottom of this post. In this morning’s press, the IDSA and CDC came out with guns blazing, denying the possibility of Lyme Rage. Dr. Gary Wormser, the lead author of the controversial Infectious Disease Society of Americe (IDSA) Lyme guidelines, said, on WebMD:

“I don't know of any convincing evidence that Lyme disease can cause violence or psychosis."

Paul Mead, a medical epidemiologist with the CDC, said in an article by Roger Schlueter of the News-Democrat:

"So the spirochete certainly can, in the lab, attach to nerve cells, and it certainly causes acute inflammation of nervous tissue," Mead said. "But whether that would cause psychiatric illness is, as far as I know, impossible to say."

While I personally find their Lyme denialism baffling, I encourage those of you interested in the science to read the peer-reviewed journal articles listed below, and decide for yourself. The News-Democrat also cites the Prague study, which says:

“In 2002, a study at the Prague Psychiatric Center involving 1,900 people found that people with psychiatric illness had about a 30 percent increased incidence of Lyme disease antibodies in their blood compared to other study participants.”

Isn’t it worth keeping our minds open to the emerging evidence that the Lyme bacteria -- a neurologically invasive spirochete just like syphilis -- could be the root cause of a myriad of psychiatric disorders that are currently considered incurable? How costly to our society and inhumane to medicate and lock up thousands of supposedly mentally ill people, when they may have a treatable bacterial infection. Lyme-Induced Psychiatric Disorders Peer-Reviewed Literature from Around the World Lyme disease: a neuropsychiatric illness. Fallon BA, Nields JA. Am J Psychiatry. 1994 Nov;151(11):1571-83.

“A broad range of psychiatric reactions have been associated with Lyme disease including paranoia, dementia, schizophrenia, bipolar disorder, panic attacks, major depression, anorexia nervosa, and obsessive-compulsive disorder.”

Late-stage neuropsychiatric Lyme borreliosis. Differential diagnosis and treatment. Fallon BA, Schwartzberg M, Bransfield R, Zimmerman B, Scotti A, Weber CA, Liebowitz MR. Psychosomatics. 1995 May-Jun;36(3):295-300.

“Although dermatologic, articular, cardiac, ophthalmologic, and neurologic manifestations are well known, it is less well known that psychiatric disorders may also arise. Depression, panic attacks, schizophrenia-like psychotic state, bipolar disorder, and dementia have been attributed to Lyme borreliosis.”

Functional brain imaging and neuropsychological testing in Lyme disease. Fallon BA, Das S, Plutchok JJ, Tager F, Liegner K, Van Heertum R. Clin Infect Dis. 1997 Jul;25 Suppl 1:S57-63. Review.

“Patients with Lyme disease may experience short-term memory loss, severe depression, panic attacks, unrelenting anxiety, impulsivity, paranoia, obsessive compulsive disorder, personality changes marked by irritability and mood swings, and rarely, manic episodes or psychotic states.”

The underdiagnosis of neuropsychiatric Lyme disease in children and adults. Fallon BA, Kochevar JM, Gaito A, Nields JA. Psychiatr Clin North Am. 1998 Sep;21(3):693-703, viii.

“In addition to the disorders listed by Kohler and Omasitis, Lyme disease appears to be capable of causing syndromes that manifest as personality change, depersonalization, mania, hallucinations, (auditory, visual, and olfactory), paranoia, cataonia with stupor and mutism, somatization disorder, obsessive compulsive disorder, violent outbursts, panic attacks and disorientation.”

The neuropsychiatric manifestations of Lyme borreliosis. Fallon BA, Nields JA, Burrascano JJ, Liegner K, DelBene D, Liebowitz MR. Psychiatr Q. 1992 Spring;63(1):95-117. Review.

“Lyme disease is aptly called the “new great imitator,” and it can imitate psychiatric disorders no less than medical ones. Psychiatrists working in endemic areas are well advised, then, to keep Lyme disease in mind as part of their differential diagnosis for a broad range of disorders including, for instance, panic attacks, somatization disorder, depression, and dementia.”

A 25-year-old woman with hallucinations, hypersexuality, nightmares, and a rash. Stein SL, Solvason HB, Biggart E, Spiegel D. Am J Psychiatry. 1996 Apr;153(4):545-51.

“The [Lyme] patient expressed a delusional belief that she was controlled by an attractive popular male former high school teacher who had put a curse on her family before her birth and was now sexually obsessed with her.”

Germany: Neurologische Klinik mit Poliklinik, Universität Freiburg. Lyme borreliosis in neurology and psychiatry Kohler J. Fortschr Med. 1990 Apr 10;108(10):191-3, 197.

“Involvements of the CNS are expressed not so much in focal deficits, as in diffuse psychopathological disorders… The clinical symptomatology may be dominated by severe psychiatric syndromes.”

Czechoslovakia: Prague Psychiatric Center T. Hajek: hajek@pcp.lf3.cuni.cz Higher prevalence of antibodies to Borrelia burgdorferi in psychiatric patients than in healthy subjects. Hájek T, Pasková B, Janovská D, Bahbouh R, Hájek P, Libiger J, Höschl C. Am J Psychiatry. 2002 Feb;159(2):297-301.

“These findings support the hypothesis that there is an association between Borrelia burgdorferi infection and psychiatric morbidity. In countries where this infection is endemic, a proportion of psychiatric inpatients may be suffering from neuropathogenic effects of Borrelia burgdorferi.”

Poland: Klinika Psychiatrii, Białymstoku. Rudnik I, Konarzewska B, Zajkowska J, Juchnowicz D, Markowski T, Pancewicz SA. Pol Merkur Lekarski. 2004 Apr;16(94):328-31.

“Mental state examinations and psychometric testing revealed in majority of the patients, mainly in those suffered from neuroborreliosis and erythrema migrans evidence of various psychiatric symptomatology. The range of psychiatric presentations included: mild cognitive deficits, organic mood disorders, mild dementias, depressive and anxiety episodes with non organic etiology.”

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http://www.neuro-lyme.com/Neurophsychiatric_Lyme.html

Lyme Disease: A Neuropsychiatric Illness

By Brian A. Fallon, M.D., M.P.H., and Jenifer A. Nields, M.D.
Am J Psychiatry 151:11, November 1994 pp.1571-1580

Objective : Lyme disease is a multisystemic illness that can affect the central nervous system (CNS), causing neurologic and psychiatric symptoms. The goal of this article is to familiarize psychiatrists with this spirochetal illness.

Method : Relevant books, articles, and abstracts from academic conferences were perused, and additional articles were located through computerized searches and reference sections from published articles.

Results : Up to 40% of patients with Lyme disease develop neurologic involvement of either the peripheral or central nervous system. Dissemination to the CNS can occur within the first few weeks after skin infection. Like syphilis, Lyme disease may have a latency period of months to years before symptoms of late infection emerge. Early signs include meningitis, encephalitis, cranial neuritis, and radiculoneuropathies. Later, encephalomyelitis and encephalopathy may occur. A broad range of psychiatric reactions have been associated with Lyme disease, including paranoia, dementia, schizophrenia, bipolar disorder, panic attacks, major depression, anorexia nervosa, and obsessive-compulsive disorder. Depressive states among patients with late Lyme disease are fairly common, ranging across studies from 26% to 66%. The microbiology of Borrelia burgdorferi sheds light on why Lyme disease can be relapsing and remitting and why it can be refractory to normal immune surveillance and standard antibiotic regimens.

Conclusions: Psychiatrists who work in endemic areas need to include Lyme disease in the differential diagnosis of any atypical psychiatric disorder. Further research is needed to identify better laboratory tests and to determine the appropriate manner (intravenous or oral) and length (weeks or months) of treatment among patients with neuropsychiatric involvement. (Am J Psychiatry 1994; 151:1571-1583)

Lyme Disease (Lyme borreliosis), caused by the tick-borne spirochete Borrelia burgdorferi, may progress from an initial skin infection to a disabling multisystemic illness. Now the most common vector-borne infection in the United States, Lyme disease is increasing in incidence and geographic spread (1). The disease has dermatologic, arthritic, ophthalmologic, cardiac, neurologic, and psychiatric manifestations (2). In its protean manifestations, in its spirochetal etiology, and in its course (early skin localization and rapid invasion of the central nervous system [CNS]), Lyme disease is similar to syphilis (3). Like syphilis, early recognition is important to prevent an acute, treatable illness from becoming a chronic or relapsing one. Because current diagnostic tests are not always reliable, physicians must rely on clinical presentation as the basis for diagnosis. Because many of the symptoms of Lyme disease involve the CNS, patients with Lyme disease may be referred to psychiatrists both before and after diagnosis.

In this article, we present an overview of Lyme disease with a particular emphasis on its neuropsychiatric features

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Open Neurol J. 2012; 6: 88–93.
Published online 2012 Oct 5. doi: 10.2174/1874205X01206010088
PMCID: PMC3474947
Suppl 1
The Psychoimmunology of Lyme/Tick-Borne Diseases and its Association with Neuropsychiatric Symptoms
Robert C Bransfield*
Author information ► Article notes ► Copyright and License information ►
This article has been cited by other articles in PMC.
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Abstract

Disease progression of neuropsychiatric symptoms in Lyme/tick-borne diseases can be better understood by greater attention to psychoimmunology. Although there are multiple contributors that provoke and weaken the immune system, infections and persistent infections are significant causes of pathological immune reactions. Immune mediated ef-fects are a significant contributor to the pathophysiological processes and disease progression. These immune effects in-clude persistent inflammation with cytokine effects and molecular mimicry and both of these mechanisms may be present at the same time in persistent infections. Sickness syndrome associated with interferon treatment and autoimmune limbic encephalopathies are models to understand inflammatory and molecular mimicry effects upon neuropsychiatric symp-toms. Progressive inflammatory reactions have been proposed as a model to explain disease progression in depression, psychosis, dementia, epilepsy, autism and other mental illnesses and pathophysiological changes have been associated with oxidative stress, excitotoxicity, changes in homocysteine metabolism and altered tryptophan catabolism. Lyme dis-ease has been associated with the proinflammatory cytokines IL-6, IL-8, IL-12, IL-18 and interferon-gamma, the chemokines CXCL12 and CXCL13 and increased levels proinflammatory lipoproteins. Borrelia burgdorferi surface gly-colipids and flagella antibodies appear to elicit anti-neuronal antibodies and anti-neuronal antibodies and Borrelia burgdorferi lipoproteins can disseminate from the periphery to inflame the brain. Autism spectrum disorders associated with Lyme/tick-borne diseases may be mediated by a combination of inflammatory and molecular mimicry mechanisms. Greater interaction is needed between infectious disease specialists, immunologists and psychiatrists to benefit from this awareness and to further understand these mechanisms.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474947/

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Terveydenhuolto 2018 , 6 (3), 104; https://doi.org/10.3390/healthcare6030104 (rekisteröinti DOI)
Neuropsykiatrinen Lyme Borreliosis: yleiskatsaus, joka keskittyy erikoispsykiatrisen kliiniseen käytäntöön
Robert C. BransfieldOrcID

Psychiatrian laitos, Rutgers-Robert Wood Johnsonin lääketieteellinen koulu, Piscataway, NJ 08854, USA
Saatu: 10. heinäkuuta 2018 / Tarkistettu: 22. elokuuta 2018 / Hyväksytty: 23. elokuuta 2018 / Julkaistu: 25.8.2018
(Tämä artikkeli kuuluu Special Issue Lyme -taudille: Suurien tietojen rooli, Companion Diagnostics ja Precision Medicine )
Näytä koko teksti | Lataa PDF [316 kt, ladattu 25 elokuuta 2018]

Abstrakti
Lisääntyvä näyttö ja tunnustaminen ovat, että Lyme borreliosis (LB) aiheuttaa henkisiä oireita. Tämä artikkeli perustuu tietokantoihin, hakukoneisiin ja kliiniseen kokemukseen tarkastella nykyisiä tietoja LB: stä. LB aiheuttaa immuuni- ja aineenvaihdunnallisia vaikutuksia, jotka johtavat vähitellen kehittyviin neuropsykiatrisiin oireisiin, jotka yleensä esiintyvät merkittävillä komorbiditeetilla, joihin voi kuulua kehitysvammoja, autismin taajuuksien häiriöitä, skitsoaffektiivisiä häiriöitä, kaksisuuntaista mielialahäiriötä, masennusta, ahdistuneisuushäiriöitä (paniikkihäiriö, sosiaalinen ahdistuneisuushäiriö, yleistynyt ahdistuneisuushäiriö, posttraumaattinen stressihäiriö, häiritsevät oireet), syömishäiriöt, alentunut libido, unihäiriöt, riippuvuus, opioidiriippuvuus, kognitiiviset häiriöt, dementia, kouristuskohtaukset, itsemurha, väkivalta, anhedonia, depersonalisaatio, dissosiaatiotapahtumat, derealisaatio ja muut arvonalentumiset. Seurannan arviointi, jota seuraa perusteellinen historia, kokonaisvaltainen psykiatrinen kliininen tentti, järjestelmien tarkastelu, psyykkinen tila tentti, neurologinen tentti ja fyysinen tentti, joka liittyy potilaan kanteluihin ja havaintoihin kliinisen arvioinnin, kuvien tunnistuksen ja laboratoriotulosten tuntemisen tulkinnan avulla. Psykotrooppiset ja antibiootit voivat auttaa parantamaan toimintaansa ja ehkäisemään taudin etenemistä. Tietoisuus LB: n ja neuropsykiatristen vajaatoimintojen välisestä yhteydestä ja niiden esiintyvyydestä neuropsykiatrisissa olosuhteissa voivat parantaa mielenterveyden ja väkivallan syiden ymmärtämistä ja johtaa tehokkaampaan ehkäisyyn, diagnosointiin ja hoitoon. Näytä koko teksti
Avainsanat: Lyme-tauti ; Borrelia burgdorferi ; tickborne sairaudet ; jatkuva tartunta ; hoito ; arviointi ; masennus ; ahdistuneisuus ; unihäiriöt ; opioidiriippuvuus
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