Post-Treatment Lyme Syndrome and Central Sensitization

Batheja, Shweta; Nields, Jenifer A.; Landa, Alla; Fallon, Ann C.

doi:10.1176/appi.neuropsych.12090223

Cited by 39 publications

(24 citation statements)

References 86 publications

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“…The pathogenesis of these symptoms is unclear and might not be the same in all patients. These symptoms might be a part of a central sensitization syndrome 179 or be attributable to immune system abnormalities, for example, increased levels of IL-23 (REF. 180) or heightened levels of anti-neuronal antibodies 181 .…”

Section: Quality Of Lifementioning

confidence: 99%

Lyme borreliosis

Steere

Strle

Wormser

et al. 2016

Nat Rev Dis Primers

645

697

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Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.

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Section: Quality Of Lifementioning

confidence: 99%

Lyme borreliosis

Steere

Strle

Wormser

et al. 2016

Nat Rev Dis Primers

645

697

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“…The differences observed for effective concentrations of DSF between alcohol-dependent patients and those suffering from PTDLS or SPPT could also be linked to a such central sensitization often observed in patients suffering from borreliosis (35).…”

Section: Discussionmentioning

confidence: 90%

“…On the other hand, many studies have reported that patients with PTLDS have an increased sensitivity to pain, which can affect vision, hearing, touch, and even smell, as reviewed by Batheja et al (35). These chronic pains can be related multiple to chemical sensitivity and chronic fatigue syndrome, in which the pain sensitivity is modified as well, as reported in Gulf war veterans (36).…”

Section: Discussionmentioning

confidence: 94%

Potential Patient-Reported Toxicities With Disulfiram Treatment in Late Disseminated Lyme Disease

Trautmann

Gascan

Ghozzi³

2020

Front. Med.

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Recently, disulfiram has been proposed as a promising treatment for people suffering from persistent symptoms of Lyme Disease. Disulfiram has several distinct molecular targets. The most well-known is alcohol dehydrogenase, a key enzyme for detoxifying the organism after alcohol ingestion. Other targets and modes of action of disulfiram, that may present problematic side effects, are less commonly mentioned. The French Federation against Tick Borne Diseases (French acronym, FFMVT), which associates three main Lyme patient organizations, MDs and PhDs, has recently been alerted to severe and persistent toxic events in a patient suffering from a late disseminated form of Lyme Disease following disulfiram intake. FFMVT reacted by launching a national call to examine whether other patients in France following a similar treatment could be identified, and what benefits, or side effects could be reported. The statements of 16 patients taking disulfiram have been collected and are presented here. Thirteen out of 16 patients reported toxic events, and seven out of 16 reported benefits for at least part of their symptoms. Based on the collected observations, it seems too early to promote disulfiram as a promising new treatment until the reasons underlying the reported toxicities have been explored, and the results of a well-conducted double blind clinical trial published. The importance of taking into account patient-reported outcomes in Lyme Disease is underlined by the present study.

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“…Finally, infection-triggered, post-infectious syndromes have been described for a variety of viruses (151). Given the clinical similarities between many of these syndromes and persistent symptoms in Lyme disease, including fibromyalgia and chronic fatigue syndrome, it has also been hypothesized that analogous underlying mechanisms may contribute to the symptom profile for all of these conditions (152). Specifically, central sensitization is a process of hyperactivation in the central neural pathways, leading to a more intense response to sensory stimuli, which is experienced as hyperalgesia and/or allodynia (152).…”

Section: Etiologymentioning

confidence: 99%