Can Lyme Disease Affect the Brain? Autopsy Findings Explained

Autopsy findings identified Borrelia species in brain tissue
Different species were detected in separate brain regions
The findings raise questions about neurologic Lyme symptoms

Can Lyme disease affect the brain? In their article, “Concurrent Infection of the Human Brain with Multiple Borrelia Species,” Golovchenko and colleagues describe a post-mortem brain autopsy involving a man who suffered for more than 10 years with neurologic and psychiatric symptoms associated with Lyme disease.

The findings raise questions about whether Borrelia species may persist in certain tissues in selected patients with chronic neurologic symptoms and how these findings relate to persistent Lyme disease mechanisms and ongoing neurologic symptoms.

The patient underwent repeated testing with “borderline positivity for Borrelia infection, followed by the prescription of several antibiotics, which provided no clinical improvements, followed by hospitalization at psychiatric clinics,” the authors state.

Case report: years of neurologic decline following Lyme disease

The 28-year-old patient first visited his physician in 2004 after developing an erythema migrans rash. He was diagnosed with Lyme disease and treated with antibiotics.

However, his condition worsened and he developed neurologic symptoms including brain fog, reduced psychomotor performance, and difficulty concentrating and processing visual and auditory stimuli. These symptoms overlap with findings commonly discussed in brain fog and Lyme disease and broader discussions of neurologic Lyme disease.

“Here we report the case of a patient who, after being infected by Borrelia and treated with antibiotics continuously, progressed toward neurologic/psychiatric symptoms over the subsequent 13 years.”

In 2017, testing was positive for Borrelia with both IgG and IgM anti-Borrelia antibodies in serum. Several months later, he was admitted to the Psychiatric Department of the University Hospital Olomouc in the Czech Republic.

Testing in February 2018 revealed borderline positivity for Borrelia-specific IgM and strong positivity for IgG.

The IgM immunoblot was positive for OspC from B. afzelii, B. garinii, and B. burgdorferi sensu stricto, while IgG findings demonstrated borderline positivity for VlsE from the same species.

The patient was prescribed combination antibiotic treatment including minocycline, azithromycin, and hydroxychloroquine.

Autopsy findings revealed Borrelia species in different brain regions

Seven months later, the patient was hospitalized again and diagnosed with schizotypal personality disorder and somatoform disorder before discharge.

One year later, the patient died by suicide.

The patient requested that researchers examine his brain tissue for evidence of Lyme disease spirochetes.

An autopsy was subsequently performed.

Researchers performed PCR analysis on different brain regions to determine whether Borrelia DNA could be identified in tissue samples.

Testing confirmed DNA from two spirochete species: B. burgdorferi and B. garinii.

Each species was identified in different parts of the brain.

The authors reported that the two species occupied separate brain regions rather than overlapping within the same location.

B. burgdorferi was identified in the temporal right lobe, choroid plexus, occipital lobe, and parietal lobe. B. garinii DNA was detected in the basal ganglia and cerebellum.

These findings contribute to broader discussions about the effects of Lyme disease on the brain and whether localization of organisms could contribute to differing neurologic symptoms.

Authors’ conclusions

The investigators concluded that multiple species from the B. burgdorferi sensu lato complex were identified in different brain regions.

They also observed that the detected species occupied distinct brain regions rather than overlapping within the same tissue locations.

The authors suggested these findings raise questions regarding persistent central nervous system involvement and neurologic symptoms in selected patients with Lyme disease.

What are the limitations of this case report?

• This is a single patient case report
• Autopsy findings may not apply broadly to all Lyme disease patients
• Detection of bacterial DNA cannot determine whether organisms caused every symptom
• Prior antibiotic exposure complicates interpretation
• Case reports cannot determine how frequently these findings occur

Frequently Asked Questions

Can Lyme disease affect the brain?

This case report identified Borrelia DNA in multiple brain regions and highlights the neurologic complications reported in selected Lyme disease patients.

Where is Borrelia burgdorferi found in the body?

This autopsy identified B. burgdorferi DNA in several brain regions including the temporal lobe, occipital lobe, parietal lobe, and choroid plexus.

Can Lyme bacteria be found in the brain?

This autopsy identified DNA from two Borrelia species in brain tissue using PCR analysis.

What did the autopsy show?

The autopsy identified DNA from B. burgdorferi and B. garinii in distinct brain regions.

Can Lyme disease be fatal?

Fatal outcomes from Lyme disease are uncommon. This report describes a complex neurologic case with significant psychiatric and neurologic complications.

Clinical Takeaway

This autopsy case raises important questions about tissue persistence, neurologic manifestations, and how different Borrelia species may interact with the central nervous system.

The detection of multiple Borrelia species in separate brain regions highlights ongoing questions about Lyme disease brain involvement and persistent neurologic symptoms after treatment.

Related Articles

These articles explore neurologic symptoms, brain involvement, and persistent manifestations of Lyme disease.

How does Lyme disease affect the brain?
Autopsy finds Lyme disease spirochetes in patient with dementia
Neurologic Lyme disease
Delayed Lyme disease diagnosis
Persistent Lyme disease mechanisms

References

1. Golovchenko M, Opelka J, Vancova M, Sehadova H, Kralikova V, Dobias M, Raska M, Krupka M, Sloupenska K, Rudenko N. Concurrent Infection of the Human Brain with Multiple Borrelia Species. Int J Mol Sci. 2023;24(23):16906.

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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention