FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome

K. Morgen, Roland Martin*, R. D. Stone, J. Grafman, N. Kadom, H. F. McFarland, A. Marques

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: To determine patterns of abnormalities on cerebral MRI that may characterize subgroups of patients with post-treatment Lyme disease syndrome (PTLDS) and to help identify pathomechanisms of disease. Methods: The authors analyzed the distribution of cerebral lesions in a cohort of 27 patients with PTLDS. A subgroup of eight patients with PTLDS was further studied using whole-brain magnetization transfer ratio measures to identify abnormalities not seen on T2-weighted images. Results: Four patients had focal neurologic deficits, relapsing-remitting disease, and lesions in a distribution typical of MS. Twenty-three patients presented with nonfocal symptoms such as fatigue, subjective memory deficits, and mood disturbance. Twelve of these patients had normal MRI, including the more sensitive fluid-attenuated inversion recovery sequence, 10 had primarily punctate and subcortical lesions, and one patient had multiple periventricular lesions. Conclusions: In a portion of patients with post-treatment Lyme disease syndrome, white-matter hyperintensities tend to occur in subcortical arteriolar watershed areas and are not specific. Magnetization transfer ratio analysis did not provide evidence for structural abnormalities of the brain parenchyma in patients with nonfocal disease.

Original languageEnglish (US)
Pages (from-to)1980-1985
Number of pages6
JournalNeurology
Volume57
Issue number11
DOIs
StatePublished - Dec 11 2001

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Patient Transfer
Lyme Disease
Therapeutics
Sequence Inversion
Memory Disorders
Brain
Neurologic Manifestations
Fatigue

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Morgen, K., Martin, R., Stone, R. D., Grafman, J., Kadom, N., McFarland, H. F., & Marques, A. (2001). FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome. Neurology, 57(11), 1980-1985. https://doi.org/10.1212/WNL.57.11.1980
Morgen, K. ; Martin, Roland ; Stone, R. D. ; Grafman, J. ; Kadom, N. ; McFarland, H. F. ; Marques, A. / FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome. In: Neurology. 2001 ; Vol. 57, No. 11. pp. 1980-1985.
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Morgen, K, Martin, R, Stone, RD, Grafman, J, Kadom, N, McFarland, HF & Marques, A 2001, 'FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome', Neurology, vol. 57, no. 11, pp. 1980-1985. https://doi.org/10.1212/WNL.57.11.1980

FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome. / Morgen, K.; Martin, Roland; Stone, R. D.; Grafman, J.; Kadom, N.; McFarland, H. F.; Marques, A.

In: Neurology, Vol. 57, No. 11, 11.12.2001, p. 1980-1985.

Research output: Contribution to journalArticle

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AU - Morgen, K.

AU - Martin, Roland

AU - Stone, R. D.

AU - Grafman, J.

AU - Kadom, N.

AU - McFarland, H. F.

AU - Marques, A.

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N2 - Objective: To determine patterns of abnormalities on cerebral MRI that may characterize subgroups of patients with post-treatment Lyme disease syndrome (PTLDS) and to help identify pathomechanisms of disease. Methods: The authors analyzed the distribution of cerebral lesions in a cohort of 27 patients with PTLDS. A subgroup of eight patients with PTLDS was further studied using whole-brain magnetization transfer ratio measures to identify abnormalities not seen on T2-weighted images. Results: Four patients had focal neurologic deficits, relapsing-remitting disease, and lesions in a distribution typical of MS. Twenty-three patients presented with nonfocal symptoms such as fatigue, subjective memory deficits, and mood disturbance. Twelve of these patients had normal MRI, including the more sensitive fluid-attenuated inversion recovery sequence, 10 had primarily punctate and subcortical lesions, and one patient had multiple periventricular lesions. Conclusions: In a portion of patients with post-treatment Lyme disease syndrome, white-matter hyperintensities tend to occur in subcortical arteriolar watershed areas and are not specific. Magnetization transfer ratio analysis did not provide evidence for structural abnormalities of the brain parenchyma in patients with nonfocal disease.

AB - Objective: To determine patterns of abnormalities on cerebral MRI that may characterize subgroups of patients with post-treatment Lyme disease syndrome (PTLDS) and to help identify pathomechanisms of disease. Methods: The authors analyzed the distribution of cerebral lesions in a cohort of 27 patients with PTLDS. A subgroup of eight patients with PTLDS was further studied using whole-brain magnetization transfer ratio measures to identify abnormalities not seen on T2-weighted images. Results: Four patients had focal neurologic deficits, relapsing-remitting disease, and lesions in a distribution typical of MS. Twenty-three patients presented with nonfocal symptoms such as fatigue, subjective memory deficits, and mood disturbance. Twelve of these patients had normal MRI, including the more sensitive fluid-attenuated inversion recovery sequence, 10 had primarily punctate and subcortical lesions, and one patient had multiple periventricular lesions. Conclusions: In a portion of patients with post-treatment Lyme disease syndrome, white-matter hyperintensities tend to occur in subcortical arteriolar watershed areas and are not specific. Magnetization transfer ratio analysis did not provide evidence for structural abnormalities of the brain parenchyma in patients with nonfocal disease.

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