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Cognitive effects of Lyme disease in children
W V Adams1, C D Rose, S C Eppes
1Department of Pediatrics, Alfred I. duPont Institute, Jefferson Medical College, Wilmington, DE 19899.
Insights
Children treated for Lyme disease (LD) show no cognitive deficits compared to healthy peers. Early treatment ensures an excellent prognosis for unimpaired cognitive function in pediatric Lyme disease patients.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuropsychology
Background:
- Lyme disease (LD) is a tick-borne illness that can affect various organ systems.
- Concerns exist regarding potential long-term cognitive effects of LD, particularly in children.
Purpose of the Study:
- To evaluate cognitive functioning in children treated for Lyme disease.
- To identify any potential cognitive sequelae associated with pediatric LD.
Main Methods:
- A prospective, blinded, controlled study was conducted.
- Forty-one children with LD were compared to 14 children with rheumatological diseases and 23 healthy siblings.
- Neuropsychological tests assessed IQ, processing speed, dexterity, problem-solving, memory, and learning; academic achievement and parental reports were also collected.
Main Results:
- No significant differences in cognitive measures were observed between children with LD and control groups.
- No cognitive differences were found based on neurologic involvement, disease stage, symptom duration, or antibiotic treatment.
- Academic performance remained stable pre- and post-disease, and parents reported no perceived long-term cognitive, social, or personality decline.
Conclusions:
- Appropriate treatment of Lyme disease in children leads to an excellent prognosis.
- Pediatric Lyme disease does not appear to result in lasting cognitive impairment when treated effectively.
Objective:
To measure possible cognitive sequelae of Lyme disease (LD) within a pediatric population.
Design:
Prospective, blinded, controlled study of cognitive skills in children who had been treated for LD.
Setting:
A children's hospital in an area endemic for LD.
Patients:
Forty-one children with strictly defined LD were compared with 14 control children who had subacute rheumatological diseases, and with 23 healthy sibling controls.
Outcome Measures:
Neuropsychologic measures were administered to each child to assess the following cognitive areas: IQ information processing speed, fine-motor dexterity, novel-problem solving and executive functioning, short-term and intermediate memory, and the ability to acquire new learning. Predisease and postdisease academic achievement test scores were also gathered. Impressions from parents concerning the disease's subsequent impact were also obtained.
Results:
No differences between LD and control groups were found for any of the numerous neuropsychologic measures. Analyses also failed to show differences between LD patients grouped with respect to the presence or absence of known neurologic involvement, disease stage, duration of symptoms before therapy, or type of antibiotic treatment. No predisease versus post-disease difference in academic performance was found. No perceived long-term deterioration in cognitive, social, or personality areas was reported by parents.
Conclusion:
Children appropriately treated for LD have an excellent prognosis for unimpaired cognitive functioning.