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Quality of Life Research

, Volume 22, Issue 1, pp 75–84

First Online: 01 February 2012Accepted: 13 January 2012DOI: 10.1007-s11136-012-0126-6

Cite this article as: Aucott, J.N., Rebman, A.W., Crowder, L.A. et al. Qual Life Res 2013 22: 75. doi:10.1007-s11136-012-0126-6


PurposeA subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome PTLDS. This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time.

MethodsSixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 daily life functioning and the Beck Depression Inventory, Second Edition BDI-II depression, at each of five visits over a period of 6 months.

ResultsSigns of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than -minimal- depression across the entire period. Those with PTLDS 36% did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months.

ConclusionsUnlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.

KeywordsPost-treatment Lyme disease syndrome Chronic disease Depression Life functioning Outcomes AbbreviationsPTLDSPost-treatment Lyme disease syndrome

EMErythema migrans

CBCComplete blood counts

CMPComplete metabolic panel

BDI-IIBeck Depression Inventory, Second Edition

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Autor: John N. Aucott - Alison W. Rebman - Lauren A. Crowder - Kathleen B. Kortte


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