1H-MRS Early Lyme Neuroborreliosis Reveals Hidden Brain Injury
The authors conducted a study to determine whether 1H-MRS early Lyme neuroborreliosis
could identify neurologic damage in patients when a standard MRI failed to do so. Proton magnetic
resonance spectroscopy (¹H-MRS) was evaluated as a tool to detect subtle brain changes in early Lyme
disease that may not be visible on conventional imaging.
Garkowski and colleagues hypothesized that magnetic resonance spectroscopy could assess neurologic
changes in Lyme disease patients by measuring alterations in cerebral metabolism.
Study Design and Patient Population
The study included 26 patients with early Lyme neuroborreliosis (LNB), ranging in age from 19 to
65 years. All participants underwent brain imaging using both MRI and ¹H-MRS either before or at
the start of antibiotic treatment.
[bctt tweet=”MRS testing reveals neurologic damage or dysfunction in the brains of patients with early Lyme disease.” username=”DrDanielCameron”]
1H-MRS Early Lyme Neuroborreliosis and Cerebral Metabolism
Results from the ¹H-MRS revealed a significant reduction in the brain metabolite
N-acetylaspartate (NAA), which is widely regarded as a marker of neuronal integrity.
According to the authors, this reduction is “likely caused by neuronal injury due to
Borrelia burgdorferi infection.”
Importantly, these metabolic changes were not visible on standard MRI scans, highlighting
the limitations of conventional imaging in detecting early neurologic injury.
“The reduction of the NAA/Cr ratio may reflect neuronal dysfunction or early neuronal damage
without visible structural abnormalities of the brain, which may signify latent
encephalopathic changes undetectable by MRI in patients with early LNB,”
the authors write.
Why MRI May Miss Early Neurologic Injury
MRI is designed to detect structural abnormalities of the brain. In contrast, magnetic
resonance spectroscopy evaluates biochemical and metabolic changes that can precede
structural injury. This may explain why patients with early Lyme neuroborreliosis can
experience cognitive or neurologic symptoms despite normal MRI findings.
Clinical Implications for Lyme Neuroborreliosis
These findings suggest that metabolic brain injury may occur early in the course of Lyme
neuroborreliosis, even when conventional imaging appears normal. This may help explain
persistent cognitive symptoms in patients with
neurologic Lyme disease who remain ill after treatment.
Editor’s note:
It would be helpful to perform ¹H-MRS testing on patients who recover from LNB to determine
whether these neurologic changes are reversible. This imaging modality may also prove useful
in evaluating chronically ill Lyme disease patients with persistent neurologic symptoms.
References:
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Garkowski A, Kubas B, Hladunski M, et al.
Neuronal loss or dysfunction in patients with early Lyme neuroborreliosis:
a proton magnetic resonance spectroscopy study of the brain.
J Neurol. 2019.
I think my brain is affected from Lyme and rmsf and Ehrlichlosis
You should see a doctor.
Im on my 19th day of antibiotics, here in Arkansas there is a huge debate over the treatment and diagnosis. I have had the rashes for wel over 5 years and they are still present. Im afraid the damage is already done, but if there is a way to use my data for progression against what is a terrible disease to live with please contact me.
My Dr has not ordered any test other than confirmation and I fear that im going to be swept under the rug.
36 year old white male no history of mental ilnes
I have held a job since i was 15 now I can barely go grocery shoping most days,
Funy how Ive always ben able to do for myself and now I pray for a miracle that may never come. This is no quality of life