What happens to the brain during acute Lyme neuroborreliosis?

A group of researchers from Tulane National Primate Research Center in Louisiana injected live Borrelia spirochete into rhesus monkeys and discovered that inflammation plays a “causal role” in the pathogenesis of acute Lyme neuroborreliosis. Their findings were published recently in The American Journal of Pathology.

Borrelia spirochete are injected into monkeys' brains.

Borrelia spirochete are injected into monkeys’ brains.

Individuals diagnosed with Lyme neuroborreliosis typically suffer from headaches, fatigue, memory loss, learning disabilities, and depression. Clinical findings have included meningitis, cranial neuritis, radiculoneuritis, encephalopathy, encephalitis, encephalomyelitis, radiculitis, radiculoneuritis, mononeuropathies, plexopathies, and demyelinating neuropathies.

Dr. Mario T. Philipp and colleagues at the Tulane National Primate Research Center launched an investigation to examine the role of inflammation on the central nervous system of subjects infected with Borrelia burgdorferi (Bb). Rhesus monkeys were injected with live Bb spirochete. Several monkeys received a potent steroid prior to being injected with the spirochete, while another group was pretreated with a non-steroidal (NSAID) medicine.

The NSAID and control group experienced extensive neurologic damage. The cerebrospinal fluid revealed significantly elevated levels of IL-6, IL-8, chemokine ligand 2, and CXCL13 and pleocytosis in the monkeys, according to a study published in The American Journal of Pathology. Additional pathological changes included:

  1. Leptomeningitis (meningitis)
  2. Vasculitis (inflammation of blood vessels in the brain)
  3. Focal inflammation in the central nervous system
  4. Necrotizing focal myelitis in the cervical spinal cord
  5. Radiculitis (pain that radiates along the nerve due to inflammation on the nerve root at its connection to the spinal column)
  6. Neuritis (inflammation of the nerves)
  7. Demyelination in the spinal roots (erosion of the myelin sheath that normally protects nerve fibers)
  8. Inflammation with neurodegeneration in the dorsal root ganglia (Inflammation and progressive loss of structure or function of neurons in the dorsal root ganglia, or spinal ganglion. The dorsal root ganglion contains the cell bodies of sensory neurons that bring information from the periphery to the spinal cord.)
  9. Neuronal and satellite glial cell apoptosis
  10. Persistent abnormal F-wave chrono dispersions localized to the nerve roots, suggesting damage to axons or demyelination, that were similar to several inflammatory demyelinating peripheral neuropathic disorders, including Guillain-Barré. (Guillain-Barre syndrome is a rare disorder in which your body’s immune system attacks your nerves.)

However, there were no inflammation in the central nervous system of the monkeys that were pretreated with the potent steroid, dexamethasone. 

While the monkey study provides insight into the benefits steroids can play when inflammation is present, it’s also important for clinicians to keep in mind the risks steroids can pose to patients with Lyme disease, as steroids can weaken an already overtaxed immune system.

Clinicians should not prescribe steroids to patients suspected of having Lyme disease, based on this primate study. Unfortunately, pretreatment with the non-steroidal medicine was not effective. Researchers and clinicians must continue to search out ways to control the immune response to Lyme disease without exposing patients to steroids.






22 Replies to "What happens to the brain during acute Lyme neuroborreliosis?"

  • Ellen Chiapperini
    08/19/2020 (1:55 pm)

    Dr. Cameron:
    I started January 1,2020 with severe chronic headaches on back, left side of head. After several tests and successful left carotid artery surgery for blockage in March, I began having neurological symptoms: mouth drooping to the right, weak muscle control of tongue, tongue going to left when I was asked to stick it out by neurologist, trouble chewing, and trouble concentrating. Those symptoms began about 10 days after carotid surgery. I have added symptoms in the last 4-6 weeks, of some difficulty swallowing, hoarseness in voice, and increased brain fog and forgetfulness. After a huge battery of tests the only thing positive was Lyme disease which was treated with 3 weeks of doxycycline, but I felt no differently. The neurologist still is trying to find the cause of ongoing symptoms.
    Do you have any insight about Lyme and what is going on with me?

    • Dr. Daniel Cameron
      08/19/2020 (6:58 pm)

      I advise my patients to follow with their neurologist. I also advise my patients not to throw in the towel on a tick borne illness so soon. Call my office at 914 666 4665 if you have any questions.

  • ilana drucker
    07/30/2020 (1:49 am)

    To what extent is disassociation due to chronic Lyme and/or Bartonella? I have an MRI showing non-specific white matters, a high result for basic myelin protein, postive Bart test, 2 + Lyme bands (39 and 41), and nearly 4 years of mostly psych symptoms, especially disassociation, depression, and panic. I’m receiving SOT treatment next week.

    • Dr. Daniel Cameron
      07/30/2020 (7:55 am)

      I assume you are referring to Supportive oligonucleotide technique (SOT) -a treatment that uses the messenger RNA to influence the genes in the Lyme or viral infection. I don’t have enough experience to address SOT. Basic myelin protein has been seen in other disorders e.g., multiple sclerosis. I have seen Lyme disease patients with dissociative symptoms. I have seen Lyme disease patients with a range of neuropsychiatric problems.

  • Jan
    06/16/2020 (7:37 am)

    Can you be diagnosed with brain and it be a mistake and be Lyme disease

    • Dr. Daniel Cameron
      06/16/2020 (8:34 am)

      Lyme disease can be confused with other neurologic diseases.

  • Evan
    06/07/2020 (4:52 pm)

    How does Borrelia cause neuronal apoptosis? Is it by drilling into neurons and destroying them from the inside?

  • Marilyn Belanger
    06/05/2020 (9:16 pm)

    I have had Lyme for 4.5 yr. I take vitamins and minerals plus curcumin and glucosamine for arthritis in knees and other joints. I am slowly getting weaker and suffering lack of energy. I have no medical help or advice. What else can I do? I know my brain has changed in many ways. It worries me.

    • Dr. Daniel Cameron
      06/06/2020 (8:57 am)

      I typically look a second time whether antibiotics might work. I also refer them to other doctors to rule out other illnesses.

  • Lauren
    05/30/2020 (5:54 pm)

    My daughter has to take steroids due to adrenal insufficiency. She had Pseudotumor Cerebri/ intracranial Hypertension with facial palsy. They never tested for Lyme. I had one doctor try to test this it fir us- it showed she was iGm positive yet nothing has been done about this. They don’t believe it can be Lyme because that doesn’t happen in Louisiana.

    • Dr. Daniel Cameron
      05/31/2020 (9:21 am)

      I find it important to include a revelation by a doctor experienced in treating Lyme diseases. It is hard to evaluate an IgM Western blot without a positive IgG Western blot. Facial palsy can be seen in Lyme disease. It could turn out to two conditions.

  • Gerri Hauser
    01/20/2020 (9:29 am)

    Is it possible for a patient diagnosed with parkinsons to have had undiagnosed lyme disease as the causative agent..is there any evidence of lyme disease causing a decrease in the production of dopamine …

    • Dr. Daniel Cameron
      01/20/2020 (1:18 pm)

      It is typically difficult to determine the cause of Parkinson’s disease. I have looked at Lyme disease in some Parkinson’s disease. Some of them have improved but they may have suffered from both conditions. I have not reviewed the literature on whether Lyme disease affects dopamine.

  • Dale Ryan
    01/16/2020 (7:53 am)

    are there any studies on the effect of tick paralysis from a female pregnant tick. My son was paralysed by such a tick came close to death and years later still has problems with brain function

    • Dr. Daniel Cameron
      01/16/2020 (8:49 am)

      There have been a shortage of studies to address your question. I typically send my patients for a neurologic workup and look a second time to determine if there might be an unresolved tick-borne infection

  • Michaela
    11/27/2019 (12:27 pm)

    Very interesting. So, what you are saying is that those with chronic inflammation (such as stressed caged animals and most humans) are affected by borreliosis, but those who are are healthy are not. I have six species of borrelia and have had severe lyme borreliosis which also turned out to be a spiritual awakening. I am managing my lyme with natural medicines, and feel fantastic. I would never want to take antibiotics. I see this disease as a symbiotic bacterial upgrade.

    • Rose Scaccia
      01/16/2020 (7:16 am)

      What is your holistic treatment plan you are using?

  • Marian Larkin
    01/13/2019 (4:01 pm)

    Dr Cameron, Thank you for your major contribution to Lyme disease care and cures Question: Can specific symptoms be attributed to Babesia. And can other symptoms be specific to Lyme and others to Bartonella, etc? Let’s say one has all 3 diseases. Can the patient and doctor sort them out, differentiate? One needs to know which symptom is from which disease to evaluate one’s progress. Thank you.

    • Dr. Daniel Cameron
      01/13/2019 (10:33 pm)

      I find it difficult to tease out which symptom goes with which disease. The patients described in studies may suffer from more than one tick borne infection.

  • Colleen
    05/25/2018 (2:49 am)

    This discusses pretreatment.
    It doesn’t not discuss post infection treatment.
    So unless someone is being treated with a steroid prior to being infected, (and was it immediately before infecting the primates?) I don’t see how this study does us any good?
    If this were to say they we’re infected and immediately given the steroid or non steroid then it may play a role.
    I do know some who are being treated with steroids post infection and seem to be holding up but when the dose is reduced they tank.

    • Dr. Daniel Cameron
      05/26/2018 (11:31 am)

      Agreed, the steroids only worked in an animal model if given before an experimental infection. The article does highlight the potential disease process.

  • Barbara Brady
    05/18/2017 (2:18 am)

    I have suffered over 30 years with lyme and several co-infections. My dr forgot to tell me for 18 years because he overlooked the labs. Well, needless to say l have suffered greatly, chronic joint pain, headaches, memory loss, dyslexic thought process and more. I hope and pray research continued and a cure can be found. Thanks to all the tiredless doctors, nurses, lab tech and research persons for their dedicated service to help victims of Lyme.

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