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

Research output: Contribution to journalJournal articleResearchpeer-review

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-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.

Original languageEnglish
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume71
Issue number6
Pages (from-to)1511-1516
ISSN1058-4838
DOIs
Publication statusPublished - 12. Sep 2020

Keywords

  • Borrelia burgdorferi
  • European Lyme neuroborreliosis
  • long-term risk
  • nationwide population-based cohort study
  • neurodegenerative disorders

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