Lyme Update: New Neuroscience Evidence

Black-legged Tick - Image via Wikipedia

Lyme Testing Details Are Changing: MyLyme ID, The New Standard
Why should we become very interested in Lyme? Why should those with psychiatric concerns even think about this odd presentation often relegated to infectious disease docs? Simple: Lyme Disease is the Great Imitator, and regularly shows clinically with significant psychiatric presentations from dementia, to depression, to our old friend here at CorePsych Blog: ADHD.

Lyme and Psychiatric Diagnosis
Lyme, in fact, again confirms my underlying proposition that ADHD symptoms often imply more than simple appearances. See the emotional and behavioral implications in this NPLDA Lyme Assessment Form from Robert C. Bransfield, M.D. [Information from patients with late stage neuropsychiatric Lyme disease (NPLD) was entered into a database to serve as a reference point for diagnosis and tracking the patient's status after diagnosis. – Also see this excellent Psychiatric Times article on Lyme and Neuropsychiatric Disorders]

And Dr Bransfield [see his article here on cognitive impairments with Lyme] goes on to say:

All involved with late state Lyme disease agree there is a large amount
of inaccurate information on this subject. This disagreement exists at every
level – journals, scientific meetings, clinical practice, media outlets,
etc. (17,18,19) Some of this disagreement can best be viewed as the normal
difference of opinion seen when scientists approach a very complex problem
from a very different perspective. To fuel the intensity of these disputes,
some approach these issues with a significant bias. The full recognition of
this illness has implications, which could effect tourism, real estate
values, disability, insurance company/managed care liability, workman's
compensation cases, motor vehicle issues, some criminal cases, and political
issues. Bias issues can adversely effect patient care, research funding, and
medical regulatory issues. Some of those previously impacted by bias now
have difficulty approaching this disease with full-unhampered objectivity.

Lyme disease is clearly a very complex disease. When considering a
similar spirochete disease, syphilis, it has been said, “To know syphilis is
to know medicine.” However, to know Lyme disease is not only to know
medicine but also neurology, psychiatry, politics, economics, and law.

And from Wikipedia:

Diffuse white matter pathology can disrupt these ubiquitous gray matter connections and could account for deficits in attention, memory, visuospatial ability, complex cognition, and emotional status. (Did I leave anything out? – And see this Wiki link also for SPECT imaging implications diagnostically.)

Other Excellent Lyme Resources:
Dr Kenneth Singleton: the Lyme Disease Solution – see page 58 for psychiatric conditions.
Check out this website for the Lyme Disease Association.
International Lyme and Associated Diseases Society website.

New NeuroScience testing with MyLyme ID The first comprehensive laboratory assessment tool.
Now we have to get more serious, for those already deeply into the long-term implications of less comprehensive testing.

The combination of B. burgdorferi (Lyme) specific memory T cell response and cytokine analysis, in conjunction with standard western blot, provides both cellular and humoral [blood] immune response, as well as patient inflammatory response assessment.  This comprehensive assessment provides the most complete clinical analysis of infection status and immune response that can be utilized to guide therapeutic intervention protocols. Review this relevant reference on LLT-MELISA Lyme from ScienceDirect June '06.

MY Lyme Immune I.D.™ Comprehensive Assessment (#5652) Includes:
1. —- Immune Tolerance Test® (ITT®)
Identifies memory T cell response specific for B. burgdorferi (Lyme) antigens, even “hidden” or low levels.
Includes a panel of B. burgdorferi (Lyme) specific antigens that offer early and late stage identification.

The specific antigens:
OspC     – Early antigen appears shortly after tick bite or transfer of the spirochete
p41        – Early and late antigen that provides mobility to the spirochete
VlsE-1   – Late antigen appears after spirochete infection
p100     – Late stage antigen
DbpA    – Essential protein needed for overall virulence

2. —- Cytokine Analysis
Analysis of B. burgdorferi (Lyme) antigen specific inflammatory immune response in patients.
Provides guidance for effective intervention protocols.
Assessment includes cytokines, chemokines, and immune growth factors:
IL-1β        IL-6        IL-8        IL-10        G-CSF        IFN-g        TNF-α

3. —- Western Blot Analysis (IgG and IgM)
Western Blot is the industry standard methodology – already frequently used.

It appears that this new level of testing will bring more clear evidence to the diagnostic table. Interestingly, the opportunity for application of even more comprehensive neurotransmitter and hormonal testing will add more interventions to the clinical treatment process.

Do drop a comment and share the details of your take on this new MyLyme testing – or your take on testing in general!

Do take a look at this video on the problem of missed Lyme and the Lyme movie Under Our Skin here on You Tube.
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