Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?

• Published in: Quality of life research Vol. 22; no. 1; pp. 75 - 84
• Main Authors: Aucott, John N., Rebman, Alison W., Crowder, Lauren A., Kortte, Kathleen B.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.02.2013; Springer Netherlands; Springer Nature B.V
• Subjects: Activities of Daily Living; Adult; Borrelia; Chronic fatigue syndrome; Chronic illnesses; Clinical outcomes; Cognition; Cohort analysis; Demography; Depression; Depression - complications; Depression - diagnosis; Depressive disorders; Diseases; Emotions; Encephalitis; Erythema; Etiology; Exanthema; Fatigue; Fatigue - etiology; Female; Fever; Glossitis, Benign Migratory; Humans; Infections; Infectious diseases; Inventories; Lyme disease; Lyme Disease - complications; Lyme Disease - drug therapy; Male; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Mental Health; Middle Aged; Pain; Pain - etiology; Patients; Personality Inventory; posttransplant lymphoproliferative disorders; Primary care; Prospective Studies; Psychiatric Status Rating Scales; Public Health; Quality of Life; Quality of Life Research; Questionnaires; Self report; Sickness Impact Profile; Social Adjustment; Sociology; Statistical analysis; Suburban areas; Symptoms; Syndrome; United States > US; Depression; Life functioning; Chronic disease; Post-treatment Lyme disease syndrome; Outcomes
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-012-0126-6

Purpose A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time. Methods Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months. Results Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than "minimal" depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months. Conclusions Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.