TY - JOUR
T1 - Risk of Neurological Disorders in Patients with European Lyme Neuroborreliosis
T2 - 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
PY - 2020/9/15
Y1 - 2020/9/15
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 associations 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 = 2067), created a gender- and age-matched comparison cohort from the general population (n = 20 670), and calculated risk estimates and hazard ratios. Results. We observed no long-term increased risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, or epilepsy. However, within the first year, 8 (0.4%) of the LNB patients developed epilepsy, compared with 20 (0.1%) of the comparison cohort (difference, 0.3%; 95% confidence interval, .02-.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. Conclusions. LNB patients did not have increased long-term risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy, or Guillain-Barré. Although the 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 associations 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 = 2067), created a gender- and age-matched comparison cohort from the general population (n = 20 670), and calculated risk estimates and hazard ratios. Results. We observed no long-term increased risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, or epilepsy. However, within the first year, 8 (0.4%) of the LNB patients developed epilepsy, compared with 20 (0.1%) of the comparison cohort (difference, 0.3%; 95% confidence interval, .02-.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. Conclusions. LNB patients did not have increased long-term risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy, or Guillain-Barré. Although the absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.
KW - Borrelia burgdorferi
KW - European Lyme neuroborreliosis
KW - Long-term risk
KW - Nationwide population-based cohort study
KW - Neurodegenerative disorders
UR - http://www.scopus.com/inward/record.url?scp=85085566158&partnerID=8YFLogxK
U2 - 10.1093/cid/ciz997
DO - 10.1093/cid/ciz997
M3 - Journal article
C2 - 31598647
SN - 1058-4838
VL - 71
SP - 1511
EP - 1516
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 6
M1 - ciz997
ER -