Table 2.

Clinical- and treatment-data of 10 patients with dementia like syndromes due to Lyme neuroborreliosis. Literature search and own cases

(Patient number), reference TX, follow-up	Pre-/post-TX: cognitive impairment, MRI	MMSE	Pre-/post-TX: other neurocognitive tests	Pre-/post-TX: CSF
(1), [53]	Loss of memory and orientation in time, unable to cope with daily activities	Nm	Nm	Cc: 285/µl; tp: 3600 mg/l
2 w benzylpenicillin IV	Mental condition improved, memory poor, needs daily help (1 year after TX)	Nm	Nm	Cc: 88/µl; tp: 700 mg/l AI: 20
(2), [54]	Reduced attention and memory, confused, completely dependent	20/30	Digit-symbol (WAIS): 3; CAT: phasic and tonic alertness at least 1 sd below controls	Cc: 89/µl; tp: 1910 mg/l; OCB+; AI: 12.6
18 m after 2 w c	Memory normal, independent; MRI: idem	29/30	Digit symbol: 11; CAT: >1 sd above controls	Cc: 2/µl; tp: 290 mg/l; AI: >12.5
(3), [55]	Progressing impairment of memory and concentration	Nm	Nm	Cc: 51/µl; tp: 260 mg/l; OCB+; AI+
9 m after start of 2 w c	Major regression of cognitive impairment	Nm	Nm	Cc: 6/µl; AI+
(4), [56]	Amnesia for recent events, disorientation	15/30	Mattis Scale 98/144	Cc: 250/µl; tp: 3000 mg/dl (sic); AI: 19.7
4 w after start of 4? or 12? w c	No cognitive impairment after reassessment; MRI: unchanged after 1 m	“No impairment in neurocognitive tests”		“CSF normal” (12 w after start of TX)
(5), [57]	Impairment of memory and “wordfinding”	18/30	CERAD: impairment of vf and recall of world list	Cc: 69/µl; tp: 3542 mg/l; lactate: 4.8 mmol/l; AI: 31.1
7 m after 2 w c followed by 3 m a	No memory problems, no problems with daily activities	27/30	CERAD: vf, recall of world list improved	Nd
(6), [39]	Rapidly progressing dementia, short-term memory severely impaired, disoriented	Nm	Nm	Cc: 44/µl; alb: 3570 mg/l; lactate: 6.1 mmol/l; OCB-; AI: 10.5
5 m after 3 w c	No signs of cognitive impairment; MRI: improvement after 5 y	Nm	Nm	Alb: 244 mg/l; AI: 581
(7), [58]	Not fully oriented, attention, concentration and short-term memory reduced	20/30	Nm	Cc: 30/µl; tp: 1540 mg/l; lactate: 2.9 mmol/l; OCB+; AI: 18.5
a) 3 w, b) 4 m and c) 15 m after 3 w c	a), b) and c): complete remission; MRI: unchanged after 15 m	a) 28/30 b) 30/30 c) 30/30	Nm	Cc: a) 19 b) 3/µl; tp: a) 540 b) 390 mg/l lactate: a) 1.9 b) 1.6 mmol/l OCB (a and b)+; AI: a) 21.1: b) 49.9
(8), [7]	Reduced attention and memory, amnesia for recent events, spatiotemporal disorientation	21/30	Nm	Cc: 45/µl; tp: 523 mg/l; OCB+; AI: 13.6
2 m after start of 4 w c	Complete recovery; MRI: unchanged	29/30	Nm	Cc: 7/µl; tp: 370 mg/l; OCB+; AI: 10.9
(9), [8]	Spatiotemporal disoriented, reduced attention and memory, optic hallucinations	17/30	IDSR-5: −3.51, IDSR-7: −2.149 (z-score); CDT: 3/9	Cc: 321/µl; tp: 2351 mg/l; OCB+; AI: 7.0
(a) 11 d, (b) 12 m after start of 2 w c	a) Improvement in all neuropsychological parameters; b) stable	a) 27/30 b) 29/30	a) IDSR 5: +0.733, IDSR 7: −0.280 (z-score); a) CDT; 7/9	Nd
(10) case report	Attention-, memory-and executive deficits	22/30	CERAD, WMS-R, MT, CDT	Cc: 61/µl; tp: 3690 mg/l; OCB+; AI: 7.4
6 w (CSF), 6 m after 3 w c	Major improvement; MRI not improved	28/30	Improvement (see Figs. 1, 2 and 3)	Cc: 17/µl; tp: 1792 mg/l; OCB+; AI: 14.1

a amoxicillin 3 × 500mg/die orally, AI Borrelia burgdorferi-specific antibody index, Alb albumin, c ceftriaxone 2 g/die intravenously, CAT computerized alertness test, Cc cell count, CDT Clock-drawing test, CERAD Consortium to Establish a Registry for Alzheimer’s Disease test, CSF cerebrospinal fluid, d days, IDSR Intercategorical Delayed Selective Reminding test, IV intravenously, m months, MMSE Mini Mental State Examination test, MRI magnetic resonance imaging, MT Memo test, Nd not done, Nm not mentioned, OCB oligoclonal banding, sd standard deviation, tp total protein, TX antibiotic treatment, vf verbal fluency, w weeks, WAIS Wechsler Adult Intelligence Scale, WMS-R Wechsler Memory Scale-Revised, y year