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.

PY - 2020

Y1 - 2020

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

C2 - 31598647

VL - 71

SP - 1511

EP - 1516

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 6

ER -