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莱姆病的神经精神表现:关于精神和认知影响的文献综述

Neuropsychiatric Manifestations of Lyme Disease: A Literature Review of Psychiatric and Cognitive Impacts.

作者信息

Šegždaitė Gabija, Aliukonytė Odeta, Pociūtė Kamilė

机构信息

Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Acta Med Litu. 2025;32(1):6-21. doi: 10.15388/Amed.2025.32.1.17. Epub 2025 Feb 18.

Abstract

BACKGROUND

Lyme disease can lead to neuropsychiatric symptoms like depression, anxiety, and cognitive issues, often mimicking primary psychiatric disorders. This paper examines the connection between Lyme disease and neuropsychiatric outcomes to improve diagnosis and treatment.

MATERIALS AND METHODS

The database was searched for scientific literature sources. Publications published in English in 2019-2024 were selected. All psychiatric symptoms and disorders found to be associated with Lyme disease were included. For neurological symptoms, the analysis focused on studies addressing cognitive dysfunction.

RESULTS

Acute neuroborreliosis may have minimal effects on the cognitive function and typically resolves well with treatment. However, some studies suggest that Lyme disease can affect the patients' cognitive abilities, leading to impairments in verbal fluency, attention, and memory, with a few isolated dementia-like cases highlighting the need for careful diagnosis. Nevertheless, recent large-scale studies show no increased risk of dementia. Regarding psychiatric symptoms, findings are also inconsistent, with some studies suggesting an increased risk of depression, anxiety, sleep disturbances, and other mental health conditions, while others find no such association.

CONCLUSIONS

There is no strong evidence supporting Lyme disease's role in long-term cognitive or psychiatric disorders. However, an early diagnosis and timely antibiotic treatment remain crucial in minimizing long-term consequences and improving patient outcomes.

摘要

背景

莱姆病可导致抑郁、焦虑和认知问题等神经精神症状,常类似原发性精神障碍。本文探讨莱姆病与神经精神结局之间的联系,以改善诊断和治疗。

材料与方法

检索数据库中的科学文献来源。选取2019 - 2024年以英文发表的出版物。纳入所有发现与莱姆病相关的精神症状和障碍。对于神经症状,分析重点是涉及认知功能障碍的研究。

结果

急性神经型疏螺旋体病对认知功能的影响可能极小,通常治疗后恢复良好。然而,一些研究表明莱姆病会影响患者的认知能力,导致语言流畅性、注意力和记忆力受损,少数孤立的类似痴呆病例凸显了仔细诊断的必要性。尽管如此,近期大规模研究显示痴呆风险并未增加。关于精神症状,研究结果也不一致,一些研究表明抑郁、焦虑、睡眠障碍和其他心理健康状况的风险增加,而另一些研究则未发现此类关联。

结论

没有有力证据支持莱姆病在长期认知或精神障碍中的作用。然而,早期诊断和及时的抗生素治疗对于将长期后果降至最低并改善患者结局仍然至关重要。

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