Neuropsychological Profile of Children after an Episode of Neuroborreliosis

Zotter, S; Koch, Johannes; Schlachter, Kurt; Katzensteiner, Susanne; Dorninger, Ludwig; Brunner, Juergen; Baumann, Matthias; Wolf‐Magele, Astrid; Schmid, Holger; Ulmer, Hanno; Hagspiel, Sonja; Kevin, Rostasy

doi:10.1055/s-0033-1349724

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…Residual symptoms and long term outcomes after treatment are subjects to debate, as some studies report cognitive deficits in children with Lyme neuroborreliosis [ 14 ], whereas other studies report normal findings in neuropsychological tests for children with Lyme neuroborreliosis after antibiotic treatment [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis in children: a systematic review

et al. 2016

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BackgroundMany aspects of pharmacological treatment of Lyme neuroborreliosis in children, such as choice of drug, dosage, and duration are subject to intense debates, leading to uncertainties in patients’ parents and healthcare providers alike. To assess the available evidence for pharmacological treatment for children with Lyme neuroborreliosis we conducted a systematic review.MethodsThe comprehensive systematic literature search included randomized-controlled trials (RCTs) and non-randomized studies (NRS) on treatment of Lyme neuroborreliosis in children (age <18 years). Our primary outcome was neurological symptoms after treatment. Risk of bias was assessed with the Cochrane risk of bias tools for RCTs and NRS. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsTwo RCTs and four NRS were eligible for inclusion. Risk of bias in RCTs and NRS was generally high. Reporting of studies was generally poor. Regarding the primary outcome neurological symptoms at 1–3 months, no statistically significant difference could be found in cohort studies between doxycycline and beta-lactam antibiotics. In two RCTs comparing penicillin G and ceftriaxone, no patient experienced residual neurological symptoms at the last reported time points. Quality of evidence according to GRADE was judged very low.ConclusionsData is scarce and with limited quality. Several issues could not be addressed due to scarcity of information. No eligible study compared different treatment durations. According to the available evidence, there seems to be no difference between different antibiotic agents for the treatment of Lyme neuroborreliosis in children regarding neurological symptoms. We found no evidence that supports extended antibiotic regimes.Review registrationSystematic review registration: CRD42014008839.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0708-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis in children: a systematic review

et al. 2016

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“…Two studies reported a good long-term clinical recovery in children with confirmed NB [43,44]. However, other studies point to both neuropsychiatric and cognitive abnormalities in children with NB [45,46]. The reason why some individuals develop clinical manifestations after NB infection while others remain asymptomatic is largely unknown.…”

Section: Discussionmentioning

confidence: 99%

The Kynurenine Pathway is Differentially Activated in Children with Lyme Disease and Tick-Borne Encephalitis

et al. 2021

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In children, tick-borne encephalitis and neuroborreliosis are common infections affecting the central nervous system. As inflammatory pathways including cytokine expression are activated in these children and appear to be of importance for outcome, we hypothesized that induction of the kynurenine pathway may be part of the pathophysiological mechanism. Inflammatory biomarkers were analyzed in cerebrospinal fluid from 22 children with tick-borne encephalitis (TBE), 34 children with neuroborreliosis (NB) and 6 children with no central nervous system infection. Cerebrospinal fluid levels of kynurenine and kynurenic acid were increased in children with neuroborreliosis compared to the comparison group. A correlation was seen between expression of several cerebrospinal fluid cytokines and levels of kynurenine and kynurenic acid in children with neuroborreliosis but not in children with tick-borne encephalitis. These findings demonstrate a strong induction of the kynurenine pathway in children with neuroborreliosis which differs from that seen in children with tick-borne encephalitis. The importance of brain kynurenic acid (KYNA) in both immune modulation and neurotransmission raises the possibility that abnormal levels of the compound in neuroborreliosis might be of importance for the pathophysiology of the disease. Drugs targeting the enzymes of this pathway may open the venue for novel therapeutic interventions.

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Clinical manifestations of Lyme neuroborreliosis in children: a review

et al. 2023

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Neuropsychological Profile of Children after an Episode of Neuroborreliosis

Abstract: Neuropsychological deficits resulting from LNB in childhood are rare. Most children had a good cognitive, emotional, and behavioral outcome.

Cited by 7 publications

References 16 publications

Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis in children: a systematic review

Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis in children: a systematic review

The Kynurenine Pathway is Differentially Activated in Children with Lyme Disease and Tick-Borne Encephalitis

Clinical manifestations of Lyme neuroborreliosis in children: a review

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