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J Neuropsychiatry Clin Neurosci 15:326-332, August 2003

© 2003 American Psychiatric Press, Inc.

Regional Cerebral Blood Flow and Cognitive Deficits in Chronic Lyme Disease

Brian A. Fallon, M.D., John Keilp, Ph.D., Isak Prohovnik, Ph.D., Ronald Van Heertum, M.D. and J. John Mann, M.D. Received October 15, 2001; revised March 5, 2002; accepted March 19, 2002. From the Lyme Disease Research Program, The NYS Psychiatric Institute, New York, New York. Address correspondence to Dr. Brian A. Fallon, NYS Psychiatric Institute, 1051 Riverside Drive, #69, New York, NY 10032

This study examined brain functioning in patients with Lyme encephalopathy. Eleven patients underwent neuropsychological tests and Xenon133-regional cerebral blood flow (rCBF) studies, using an external detector system. Each rCBF scan was age- and sex-matched to two archival, normal controls. While few differences were noted on gray-matter flow indices (ISI, fg), Lyme patients demonstrated significant flow reductions in white matter index (k2) (p=.004), particularly in the posterior temporal and parietal lobes bilaterally (p=.003). Flow reductions in white matter areas were significantly associated with deficits in memory (r=.66, p=.027) and visuospatial organization (r=.62, p=.041). Results suggest that Lyme encephalopathy may be a disease primarily affecting the cerebral white matter.

Key Words: Regional Cerebral Blood Flow o Lyme Disease o Encephalopathy o Functional Imaging

Dr. Fallon received support from a New York State Psychiatric Institute Research Support Grant & from the Lyme Disease Association to conduct this study.