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Lyme Update: New Neuroscience Evidence

by Dr Charles Parker on July 5, 2010 · 1 comment

Thanks for your continued interest in evolving mind/body science! Stay tuned for more details on how neurotransmitters, immune system challenges and hormones create problems with mind-balance.
The blacklegged tick (Ixodes scapularis), the ...

Black-legged Tick - Image via Wikipedia

Lyme Testing Details Are Changing: MyLyme ID, The New Standard
Why should we become very interested in Lyme? Why should those with psychiatric concerns even think about this odd presentation often relegated to infectious disease docs? Simple: Lyme Disease is the Great Imitator, and regularly shows clinically with significant psychiatric presentations from dementia, to depression, to our old friend here at CorePsych Blog: ADHD.

Lyme and Psychiatric Diagnosis
Lyme, in fact, again confirms my underlying proposition that ADHD symptoms often imply more than simple appearances. See the emotional and behavioral implications in this NPLDA Lyme Assessment Form from Robert C. Bransfield, M.D. [Information from patients with late stage neuropsychiatric Lyme disease (NPLD) was entered into a database to serve as a reference point for diagnosis and tracking the patient's status after diagnosis. - Also see this excellent Psychiatric Times article on Lyme and Neuropsychiatric Disorders]

And Dr Bransfield [see his article here on cognitive impairments with Lyme] goes on to say:

All involved with late state Lyme disease agree there is a large amount
of inaccurate information on this subject. This disagreement exists at every
level – journals, scientific meetings, clinical practice, media outlets,
etc. (17,18,19) Some of this disagreement can best be viewed as the normal
difference of opinion seen when scientists approach a very complex problem
from a very different perspective. To fuel the intensity of these disputes,
some approach these issues with a significant bias. The full recognition of
this illness has implications, which could effect tourism, real estate
values, disability, insurance company/managed care liability, workman’s
compensation cases, motor vehicle issues, some criminal cases, and political
issues. Bias issues can adversely effect patient care, research funding, and
medical regulatory issues. Some of those previously impacted by bias now
have difficulty approaching this disease with full-unhampered objectivity.

Lyme disease is clearly a very complex disease. When considering a
similar spirochete disease, syphilis, it has been said, “To know syphilis is
to know medicine.” However, to know Lyme disease is not only to know
medicine but also neurology, psychiatry, politics, economics, and law
.

And from Wikipedia:

Diffuse white matter pathology can disrupt these ubiquitous gray matter connections and could account for deficits in attention, memory, visuospatial ability, complex cognition, and emotional status. (Did I leave anything out? – And see this Wiki link also for SPECT imaging implications diagnostically.)

Other Excellent Lyme Resources:
Dr Kenneth Singleton: the Lyme Disease Solution – see page 58 for psychiatric conditions.
Check out this website for the Lyme Disease Association.
International Lyme and Associated Diseases Society website.

New NeuroScience testing with MyLyme ID The first comprehensive laboratory assessment tool.
Now we have to get more serious, for those already deeply into the long-term implications of less comprehensive testing.

The combination of B. burgdorferi (Lyme) specific memory T cell response and cytokine analysis, in conjunction with standard western blot, provides both cellular and humoral [blood] immune response, as well as patient inflammatory response assessment.  This comprehensive assessment provides the most complete clinical analysis of infection status and immune response that can be utilized to guide therapeutic intervention protocols. Review this relevant reference on LLT-MELISA Lyme from ScienceDirect June ’06.

MY Lyme Immune I.D.™ Comprehensive Assessment (#5652) Includes:
1. —- Immune Tolerance Test® (ITT®)
Identifies memory T cell response specific for B. burgdorferi (Lyme) antigens, even “hidden” or low levels.
Includes a panel of B. burgdorferi (Lyme) specific antigens that offer early and late stage identification.

The specific antigens:
OspC     – Early antigen appears shortly after tick bite or transfer of the spirochete
p41        – Early and late antigen that provides mobility to the spirochete
VlsE-1   – Late antigen appears after spirochete infection
p100     – Late stage antigen
DbpA    – Essential protein needed for overall virulence

2. —- Cytokine Analysis
Analysis of B. burgdorferi (Lyme) antigen specific inflammatory immune response in patients.
Provides guidance for effective intervention protocols.
Assessment includes cytokines, chemokines, and immune growth factors:
IL-1β        IL-6        IL-8        IL-10        G-CSF        IFN-g        TNF-α

3. —- Western Blot Analysis (IgG and IgM)
Western Blot is the industry standard methodology – already frequently used.

It appears that this new level of testing will bring more clear evidence to the diagnostic table. Interestingly, the opportunity for application of even more comprehensive neurotransmitter and hormonal testing will add more interventions to the clinical treatment process.

Do drop a comment and share the details of your take on this new MyLyme testing – or your take on testing in general!

Do take a look at this video on the problem of missed Lyme and the Lyme movie Under Our Skin here on You Tube.
cp

Make sure you take a look at these pages!
ADHD Medication Rules Purchase
“Rules” Affiliate Link
Neuroscience Details

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SPECT Brain: NPH-Normal Pressure Hydrocephalus

by Dr Charles Parker on September 28, 2008 · 2 comments

A Different View
SPECT: Single Photon Emission Computed Tomography putting the T in SPECT Brain Imaging.

Lake Michigan

The Tomographic View: The operational word for this post is Tomography… these slices make a difference for NPH: Normal Pressure Hydrocephalus – see the “TV Commercial” [showing the typical gait] at the bottom of this page and I’ll tell you a brief story about the one, the NPH one, that almost got away.

This is a shot of what I saw on [many] tomographic views/slices provided by the patient for the second opinion. The surface 3-D renderings, looked actually quite good – but looking at the slices, the inside of the brain, there was another story.

Take a quick look at this brain sliced tomographically with SPECT imaging, and see if you see what immediately came to my attention: Those blue areas in the center simply shouldn’t look like this: these pictures are the blue holes of swollen ventricles, on multiple levels, multiple slices.

Clinical Findings
But let’s start at the beginning: Chief Complaint in this 65 yo male: memory deterioration, long standing ADD symptoms recently worse, no head injury, and, yes, some clear metabolic problems… – but the big finding in the tomographic slices – big holes in the center of the brain, where the ventricles have swollen and ballooned out. Those blue areas are the ventricles, filled with cerebral spinal fluid, pushing the brain out against the skull. And for the neurologists out there… no fixed gait, no incontinence – in fact he is “compulsive” about working out.

The 3-D surface SPECT images
[from another SPECT center - not Amen Clinics] showed some typical findings: prefrontal cooling with a history of ADD, temporal lobe cooling with not understanding communications well, and anger out-of-the-blue. His previous SPECT report pronounced him free of Alzheimer’s and no frontal-temporal dementia – but this is the beginning of the rest of the story.

The tomography told a different story for this atypical “healthy guy,” with memory problems and a history of ADD.

Take a look at this relatively optimistic commentary:
The Neurology Channel gives this additional overview:

“Normal pressure hydrocephalus (NPH) is a condition that involves the build-up of fluid in the brain. Normally, a fluid called cerebrospinal fluid (CSF) circulates around the brain and spinal cord. This fluid cushions, cleanses, and brings nutrients to the cells in the brain and spine. CSF is produced in small, hollow spaces within the brain called ventricles. For people in good health, excess CSF normally drains away into the bloodstream as fresh CSF is produced.

When cerebrospinal fluid does not drain properly, the cerebrospinal fluid builds up in the ventricles and NPH can occur. This build up puts pressure on the brain, interfering with healthy brain function. NPH most commonly affects the areas of the brain that control leg movement, bladder function, and cognitive abilities such as problem solving, speaking, and remembering.

Hydrocephalus‘ was once called ‘water on the brain,’ but we now know that the water is CSF. The term ‘normal pressure’ refers to the fact that this type of hydrocephalus, which generally develops slowly, has a lower CSF-pressure than other types of hydrocephalus. Normal pressure hydrocephalus occurs mainly in people over the age of 60 and symptoms may be mistaken for other disorders, such as Parkinson’s disease, Alzheimer’s disease, dementia, or Creutzfeldt-Jakob disease. However, with proper diagnosis and treatment many of the symptoms of NPH can be controlled or greatly reduced. In some cases, a nearly complete recovery is possible.”

Shunt technology, to run the CSF back into the blood stream, has improved and this condition can likely be significantly corrected. This SPECT case proved the truth of the axiom: we do need to look at the brain to see what’s going on, and in this case, inside the brain-
cp

Make sure you take a look at these pages!
ADHD Medication Rules Purchase
“Rules” Affiliate Link
Neuroscience Details

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Brain Plasiticity: Not a Dream, But Reality

December 3, 2007 Brain Injury

There is now widespread consensus among neuroscientists that the brain retains its ability to change throughout life, but that wasn’t always the case. Just a few decades ago, most scientists believed that different areas of the brain were “hard-wired” shortly after birth to handle different aspects of brain function.

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Never Give Up: Healing The Brain, Brain Plasticity

November 30, 2007 Beyond ADHD

The interesting news about brain injury and aging: specific interventions can encourage brain/dendritic plasticity, brain healing, and [one of my favorite terms:] neurodendritic rearborization. Hang on it gets easier if you read more about it.

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Iodine Deficiency 4: ADD: Why Test before pregnancy for Iodine?

May 17, 2007 Beyond ADHD

Iodine, Pregnancy and ADD Continued:          Iodine deficiency is a sleeper, and significantly related to fibrocystic breast disease, estrogen metabolism and estrogen dominance [more later], multiple pesticides and xenoestrogens, chlorine, fluorine, and bromine in so many of our everyday foods, water and hygiene products [toothpaste]. All of these substances bump iodine out of [...]

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Mold Madness: Neurotoxins Overlooked 3

April 7, 2007 Brain Injury

The complexity of this psych presentation encourages missing an important underlying cause. More problems require more complete answers.

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Mold Madness: Neurotoxins Overlooked 2

April 6, 2007 Autism Spectrum

Mold neurotoxins can leave significant medical and psychiatric consequences. A few points of orientation: Not all mold is toxic: Penicillin is a mold. Some molds, like black mold [Stachybotrys], clearly leave a variety of toxic medical consequences. To name a few: chronic headaches depression epileptic-like seizures equilibrium or balance loss fatigue loss of memory loss [...]

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Mold Madness: Neurotoxins Overlooked 1

April 4, 2007 Brain Injury

Many Molds are dangerously Neurotoxic: Sick Buildings Deliver Crippling Brain and Body Blows. “A 1984 World Health Organization report into the syndrome suggested up to 30% of new and remodeled buildings worldwide may be linked to symptoms of Sick Building Syndrome.” Wikipedia Our experience is that the older, wet, damaged buildings have an even higher [...]

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ADD: The Media, the Meds and the Madness

January 21, 2007 Beyond ADHD

ADD: The Media, the Meds, and the Madness Episode 1: The diagnosis If we start with the right diagnosis, and recognize complexity of the spectrum of ADD, we will be much more capable of finding the right solution. This is the first in a series regarding right diagnosis, right meds, wrong meds, and metabolic issues [...]

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