Cognitive impairments in patients with persistent symptoms attributed to Lyme disease
Abstract Background Persistent symptoms attributed to Lyme borreliosis often include self-reported cognitive impairment. However, it remains unclear whether these symptoms can be substantiated by objective cognitive testing. Methods For this observational study, cognitive performance was assessed in...
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| Language: | English |
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BMC
2019-10-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4452-y |
| _version_ | 1818878889393389568 |
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| author | Anneleen Berende Joost Agelink van Rentergem Andrea W. M. Evers Hadewych J. M. ter Hofstede Fidel J. Vos Bart Jan Kullberg Roy P. C. Kessels |
| author_facet | Anneleen Berende Joost Agelink van Rentergem Andrea W. M. Evers Hadewych J. M. ter Hofstede Fidel J. Vos Bart Jan Kullberg Roy P. C. Kessels |
| author_sort | Anneleen Berende |
| collection | DOAJ |
| description | Abstract Background Persistent symptoms attributed to Lyme borreliosis often include self-reported cognitive impairment. However, it remains unclear whether these symptoms can be substantiated by objective cognitive testing. Methods For this observational study, cognitive performance was assessed in 280 adults with persistent symptoms attributed to Lyme borreliosis (as part of baseline data collected for the Dutch PLEASE study). Cognitive testing covered the five major domains: episodic memory, working memory / attention, verbal fluency, information-processing speed and executive function. Patients’ profiles of test scores were compared to a large age-, education- and sex-adjusted normative sample using multivariate normative comparison. Performance validity was assessed to detect suboptimal effort, and questionnaires were administered to measure self-reported cognitive complaints, fatigue, anxiety, depressive symptoms and several other psychological factors. Results Of 280 patients, one was excluded as the test battery could not be completed. Of the remaining 279 patients, 239 (85.4%) displayed sufficient performance validity. Patients with insufficient performance validity felt significantly more helpless and physically fatigued, and less orientated. Furthermore, they had a lower education level and less often paid work. Of the total study cohort 5.7% (n = 16) performed in the impaired range. Among the 239 patients who displayed sufficient performance validity, 2.9% (n = 7) were classified as cognitively impaired. No association between subjective cognitive symptoms and objective impairment was found. Conclusions Only a small percentage of patients with borreliosis-attributed persistent symptoms have objective cognitive impairment. Performance validity should be taken into account in neuropsychological examinations of these patients. Self-report questionnaires are insufficiently valid to diagnose cognitive impairment. Trial registration ClinicalTrials.gov NCT01207739. Registered 23 September 2010. |
| first_indexed | 2024-12-19T14:21:21Z |
| format | Article |
| id | doaj.art-12a20a4766e048e5ae07a364d773389d |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-19T14:21:21Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-12a20a4766e048e5ae07a364d773389d2022-12-21T20:17:45ZengBMCBMC Infectious Diseases1471-23342019-10-011911610.1186/s12879-019-4452-yCognitive impairments in patients with persistent symptoms attributed to Lyme diseaseAnneleen Berende0Joost Agelink van Rentergem1Andrea W. M. Evers2Hadewych J. M. ter Hofstede3Fidel J. Vos4Bart Jan Kullberg5Roy P. C. Kessels6Department of Internal Medicine 463 and Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Psychology, University of AmsterdamDepartment of Medical Psychology, Radboud University Medical CenterDepartment of Internal Medicine 463 and Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Internal Medicine 463 and Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Internal Medicine 463 and Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Medical Psychology, Radboud University Medical CenterAbstract Background Persistent symptoms attributed to Lyme borreliosis often include self-reported cognitive impairment. However, it remains unclear whether these symptoms can be substantiated by objective cognitive testing. Methods For this observational study, cognitive performance was assessed in 280 adults with persistent symptoms attributed to Lyme borreliosis (as part of baseline data collected for the Dutch PLEASE study). Cognitive testing covered the five major domains: episodic memory, working memory / attention, verbal fluency, information-processing speed and executive function. Patients’ profiles of test scores were compared to a large age-, education- and sex-adjusted normative sample using multivariate normative comparison. Performance validity was assessed to detect suboptimal effort, and questionnaires were administered to measure self-reported cognitive complaints, fatigue, anxiety, depressive symptoms and several other psychological factors. Results Of 280 patients, one was excluded as the test battery could not be completed. Of the remaining 279 patients, 239 (85.4%) displayed sufficient performance validity. Patients with insufficient performance validity felt significantly more helpless and physically fatigued, and less orientated. Furthermore, they had a lower education level and less often paid work. Of the total study cohort 5.7% (n = 16) performed in the impaired range. Among the 239 patients who displayed sufficient performance validity, 2.9% (n = 7) were classified as cognitively impaired. No association between subjective cognitive symptoms and objective impairment was found. Conclusions Only a small percentage of patients with borreliosis-attributed persistent symptoms have objective cognitive impairment. Performance validity should be taken into account in neuropsychological examinations of these patients. Self-report questionnaires are insufficiently valid to diagnose cognitive impairment. Trial registration ClinicalTrials.gov NCT01207739. Registered 23 September 2010.http://link.springer.com/article/10.1186/s12879-019-4452-yLyme diseaseCognitive neuropsychologyCognitionBorrelia |
| spellingShingle | Anneleen Berende Joost Agelink van Rentergem Andrea W. M. Evers Hadewych J. M. ter Hofstede Fidel J. Vos Bart Jan Kullberg Roy P. C. Kessels Cognitive impairments in patients with persistent symptoms attributed to Lyme disease BMC Infectious Diseases Lyme disease Cognitive neuropsychology Cognition Borrelia |
| title | Cognitive impairments in patients with persistent symptoms attributed to Lyme disease |
| title_full | Cognitive impairments in patients with persistent symptoms attributed to Lyme disease |
| title_fullStr | Cognitive impairments in patients with persistent symptoms attributed to Lyme disease |
| title_full_unstemmed | Cognitive impairments in patients with persistent symptoms attributed to Lyme disease |
| title_short | Cognitive impairments in patients with persistent symptoms attributed to Lyme disease |
| title_sort | cognitive impairments in patients with persistent symptoms attributed to lyme disease |
| topic | Lyme disease Cognitive neuropsychology Cognition Borrelia |
| url | http://link.springer.com/article/10.1186/s12879-019-4452-y |
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