How does Lyme disease affect the brain?

Physicians reviewing MRI to review how does Lyme disease affect the brain.

Lyme disease can lead to acute and chronic disturbances of the brain including encephalopathy, meningitis, neuropsychiatric disease, central sensitization syndrome, visual disturbances, and Bell's palsy (paralysis of the facial muscles). In a recent study, researchers described what Lyme disease can do to your brain.

Marvel and colleagues administered working memory tests to 12 subjects with Post Treatment Lyme disease (PTLD) and 18 healthy controls while undergoing functional MRI (fMRI). Investigators aimed to determine, using multimodal neuroimaging methods, how Lyme disease may affect the brain. A fMRI looks at the function of the brain by detecting the changes in blood flow in response to neural activity.

In their article “A multimodal neuroimaging study of brain abnormalities and clinical correlates in post treatment Lyme disease,” the authors were able to demonstrate that individuals in the PTLD group showed altered task-related activations.¹

In several regions of the brain, the study found reductions in blood flow in individuals with PTLD compared to controls.

Furthermore, individuals with “PTLD responded more slowly, but no less accurately, than did controls,” wrote the authors.

“Together, these results show that the brain is altered by PTLD, involving changes to white matter within the frontal lobe.”

There were areas of the brain in individuals with PTLD which showed higher activity. “Higher axial diffusivity may reflect white matter repair and healing over time, rather than pathology, and cognition appears to be dynamically affected throughout this repair process,” wrote the authors.

“The PTLD group relied on compensatory mechanisms to complete the task, given that they performed as well as controls did,” the authors pointed out.

The study highlighted the importance of white matter findings in individuals with PTLD.

“The relationship of these unexpected white matter findings to the clinical features of PTLD suggest that white matter abnormalities may have an important role in the symptomatology of PTLD.”

According to the authors, “results reported here may have implications for other diseases in which white matter pathology has been demonstrated (e.g., multiple sclerosis) or in illnesses in which cognitive complaints follow disease onset in the absence of objective methods to confirm neuropathology (e.g., chronic fatigue syndrome, fibromyalgia, post-acute COVID.)”

The use of multimodal neuroimaging methods, the authors wrote, “may be a viable approach for obtaining information on brain function and structure to identify biomarkers of disease burden.”

Note: The study is limited by the small size and stringent inclusion criteria.


  1. Marvel CL, Alm KH, Bhattacharya D, Rebman AW, Bakker A, Morgan OP, et al. (2022) A multimodal neuroimaging study of brain abnormalities and clinical correlates in post treatment Lyme disease. PLoS ONE 17(10): e0271425.

11 Replies to "How does Lyme disease affect the brain?"

  • Dale ryan
    03/26/2024 (8:55 am)

    52 year old chronic Lyme psychiatric symptoms confusionhearing sensitivity no treatment Paralysed by tick at 4 yrs old Is there any help at all None in Australia

  • Christine Sinclair
    03/25/2024 (4:48 am)

    I have very slurred speech which has caused me a lot of distress. I tested positive for Lyme, Bartonella and Babesia in 2021. I have had all the treatment I can afford, various antibiotics, IV and oral. Overall I am well but no significant improvement to the speech so I am now assuming irreversible damage?

  • Marg
    03/18/2024 (6:41 am)

    I have had Lyme disease for almost ten years, and have been on and off antibiotics throughout this period. About eight months ago I started having a lot of eye pain, and a feeling of something in my eye. Im now starting to have occasional blurry vision. Would this mean that I was possibly on the wrong antibiotics?

    • Sandra
      03/24/2024 (11:57 am)

      Did you test positive for Babesia? If so, were you treated for that along with the Lyme?

    • Doug R
      03/24/2024 (4:49 pm)

      Dr Rawls book Unlocking Lyme explains a lot. You can put Lyme in a test tube and pulse it with antibiotics and it still will not kill all the Lyme so how are antibiotics going to? Only time I would take antibiotics is if my symptoms were so bad I had to lower my load so my immune system can kick in.
      His supplements did wonders for me.

    • Fred
      04/19/2024 (3:01 am)

      Blurry vision can be caused by ocular infections with Bartonella and Borrelia pathogens. Borrelia treatment with Doxy or Amoxil antibiotics is a must. Ocular Bartonella is treated with Doxycycline + Rifampin for four to six weeks for complete resolution of the symptoms.

  • Carlton
    11/30/2022 (5:50 pm)

    I have been treated for lymes in early May and late October I started having pain in my index finger main joints. Recently one index finger had turned a purplish color. Is there any correlation between the two?

    • Dr. Daniel Cameron
      12/02/2022 (11:58 am)

      I have had Lyme disease patients with bluish extremities associated with dysautonomia.

  • dina ledford
    11/28/2022 (9:42 pm)

    my daughter began having seizures about a year after being treated for lyme arthritis. Is there any other similar situations?

    • Dr. Daniel Cameron
      11/30/2022 (7:16 am)

      I have Lyme disease patients in my practice whose develop neurologic problems after resolution of their rheumatologic condition. Their seizures persist despite a thorough neurologic assessment. The seizures are often atypical. There are usually other symptoms between seizures. I have found treatment for Lyme disease helpful for some of these cases.

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