Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study

Rasmus Haahr, Malte M Tetens, Ram B Dessau, Karen A Krogfelt, Jacob Bodilsen, Nanna S Andersen, Jens K Møller, Casper Roed, Claus B Christiansen, Svend Ellermann-Eriksen, Jette M Bangsborg, Klaus Hansen, Thomas L Benfield, Christian Østergaard Andersen, Niels Obel, Anne-Mette Lebech, Lars H Omland

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: Lyme neuroborreliosis (LNB) caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex has been suggested to be associated with a range of neurological disorders. In a nationwide population-based cohort-study we examined the association between LNB and dementia, Alzheimer's disease, Parkinson's disease, motor neuron disease, epilepsy and Guillain-Barré syndrome.

METHODS: We used national registers to identify all Danish residents diagnosed during 1986-2016 with LNB (n=2,067) and a gender and age matched comparison cohort from the general population (n=20,670), and calculated risk estimates and hazard ratios (HR).

RESULTS: We observed no long-term increased risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases or epilepsy. However, within the first year eight (0.4%) of the LNB patients developed epilepsy compared with 20 (0.1%) of the comparison cohort (difference 0.3%, 95% CI: 0.02% to 0.6%). In the LNB group 11 (0.5%) patients were diagnosed with Guillain-Barré syndrome within the first year after LNB diagnosis compared with 0 (0.0%) in the comparison cohort. After the first year, the risk of Guillain-Barré was not increased.

CONCLUSION: LNB patients did not have increased long-term risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy or Guillain-Barré. Although absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.

Fingeraftryk

Lyme Neuroborreliosis
Nervous System Diseases
Cohort Studies
Motor Neuron Disease
Population
Parkinson Disease
Alzheimer Disease

Citer dette

Haahr, Rasmus ; Tetens, Malte M ; Dessau, Ram B ; Krogfelt, Karen A ; Bodilsen, Jacob ; Andersen, Nanna S ; Møller, Jens K ; Roed, Casper ; Christiansen, Claus B ; Ellermann-Eriksen, Svend ; Bangsborg, Jette M ; Hansen, Klaus ; Benfield, Thomas L ; Østergaard Andersen, Christian ; Obel, Niels ; Lebech, Anne-Mette ; Omland, Lars H. / Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study. I: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2019.
@article{cd5a159760d941ac9b3f2607563a6375,
title = "Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study",
abstract = "BACKGROUND: Lyme neuroborreliosis (LNB) caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex has been suggested to be associated with a range of neurological disorders. In a nationwide population-based cohort-study we examined the association between LNB and dementia, Alzheimer's disease, Parkinson's disease, motor neuron disease, epilepsy and Guillain-Barr{\'e} syndrome.METHODS: We used national registers to identify all Danish residents diagnosed during 1986-2016 with LNB (n=2,067) and a gender and age matched comparison cohort from the general population (n=20,670), and calculated risk estimates and hazard ratios (HR).RESULTS: We observed no long-term increased risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases or epilepsy. However, within the first year eight (0.4{\%}) of the LNB patients developed epilepsy compared with 20 (0.1{\%}) of the comparison cohort (difference 0.3{\%}, 95{\%} CI: 0.02{\%} to 0.6{\%}). In the LNB group 11 (0.5{\%}) patients were diagnosed with Guillain-Barr{\'e} syndrome within the first year after LNB diagnosis compared with 0 (0.0{\%}) in the comparison cohort. After the first year, the risk of Guillain-Barr{\'e} was not increased.CONCLUSION: LNB patients did not have increased long-term risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy or Guillain-Barr{\'e}. Although absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barr{\'e} syndrome.",
author = "Rasmus Haahr and Tetens, {Malte M} and Dessau, {Ram B} and Krogfelt, {Karen A} and Jacob Bodilsen and Andersen, {Nanna S} and M{\o}ller, {Jens K} and Casper Roed and Christiansen, {Claus B} and Svend Ellermann-Eriksen and Bangsborg, {Jette M} and Klaus Hansen and Benfield, {Thomas L} and {{\O}stergaard Andersen}, Christian and Niels Obel and Anne-Mette Lebech and Omland, {Lars H}",
note = "{\circledC} The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.",
year = "2019",
month = "10",
day = "9",
doi = "10.1093/cid/ciz997",
language = "English",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Heinemann",

}

Haahr, R, Tetens, MM, Dessau, RB, Krogfelt, KA, Bodilsen, J, Andersen, NS, Møller, JK, Roed, C, Christiansen, CB, Ellermann-Eriksen, S, Bangsborg, JM, Hansen, K, Benfield, TL, Østergaard Andersen, C, Obel, N, Lebech, A-M & Omland, LH 2019, 'Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/cid/ciz997

Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study. / Haahr, Rasmus; Tetens, Malte M; Dessau, Ram B; Krogfelt, Karen A; Bodilsen, Jacob; Andersen, Nanna S; Møller, Jens K; Roed, Casper; Christiansen, Claus B; Ellermann-Eriksen, Svend; Bangsborg, Jette M; Hansen, Klaus; Benfield, Thomas L; Østergaard Andersen, Christian; Obel, Niels; Lebech, Anne-Mette; Omland, Lars H.

I: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 09.10.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study

AU - Haahr, Rasmus

AU - Tetens, Malte M

AU - Dessau, Ram B

AU - Krogfelt, Karen A

AU - Bodilsen, Jacob

AU - Andersen, Nanna S

AU - Møller, Jens K

AU - Roed, Casper

AU - Christiansen, Claus B

AU - Ellermann-Eriksen, Svend

AU - Bangsborg, Jette M

AU - Hansen, Klaus

AU - Benfield, Thomas L

AU - Østergaard Andersen, Christian

AU - Obel, Niels

AU - Lebech, Anne-Mette

AU - Omland, Lars H

N1 - © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

PY - 2019/10/9

Y1 - 2019/10/9

N2 - BACKGROUND: Lyme neuroborreliosis (LNB) caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex has been suggested to be associated with a range of neurological disorders. In a nationwide population-based cohort-study we examined the association between LNB and dementia, Alzheimer's disease, Parkinson's disease, motor neuron disease, epilepsy and Guillain-Barré syndrome.METHODS: We used national registers to identify all Danish residents diagnosed during 1986-2016 with LNB (n=2,067) and a gender and age matched comparison cohort from the general population (n=20,670), and calculated risk estimates and hazard ratios (HR).RESULTS: We observed no long-term increased risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases or epilepsy. However, within the first year eight (0.4%) of the LNB patients developed epilepsy compared with 20 (0.1%) of the comparison cohort (difference 0.3%, 95% CI: 0.02% to 0.6%). In the LNB group 11 (0.5%) patients were diagnosed with Guillain-Barré syndrome within the first year after LNB diagnosis compared with 0 (0.0%) in the comparison cohort. After the first year, the risk of Guillain-Barré was not increased.CONCLUSION: LNB patients did not have increased long-term risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy or Guillain-Barré. Although absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.

AB - BACKGROUND: Lyme neuroborreliosis (LNB) caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex has been suggested to be associated with a range of neurological disorders. In a nationwide population-based cohort-study we examined the association between LNB and dementia, Alzheimer's disease, Parkinson's disease, motor neuron disease, epilepsy and Guillain-Barré syndrome.METHODS: We used national registers to identify all Danish residents diagnosed during 1986-2016 with LNB (n=2,067) and a gender and age matched comparison cohort from the general population (n=20,670), and calculated risk estimates and hazard ratios (HR).RESULTS: We observed no long-term increased risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases or epilepsy. However, within the first year eight (0.4%) of the LNB patients developed epilepsy compared with 20 (0.1%) of the comparison cohort (difference 0.3%, 95% CI: 0.02% to 0.6%). In the LNB group 11 (0.5%) patients were diagnosed with Guillain-Barré syndrome within the first year after LNB diagnosis compared with 0 (0.0%) in the comparison cohort. After the first year, the risk of Guillain-Barré was not increased.CONCLUSION: LNB patients did not have increased long-term risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy or Guillain-Barré. Although absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.

U2 - 10.1093/cid/ciz997

DO - 10.1093/cid/ciz997

M3 - Journal article

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

ER -