SPECT Brain Imaging in Chronic Lyme Disease

[RustyJ]

Don't know if this has been picked up before.

Clinical Nuclear Medicine:
September 2012 - Volume 37 - Issue 9 - p e219–e222
doi: 10.1097/RLU.0b013e318262ad9b
Original Articles


SPECT Brain Imaging in Chronic Lyme Disease

Donta, Sam T. MD*; Noto, Richard B. MD†; Vento, John A. MD‡

​

Abstract​

Objectives: Lyme disease is an infectious disease that frequently involves the central nervous system, leading to cognitive and/or mood dysfunction. The basis for these symptoms remains to be defined but may be the result of a vasculitis or metabolic abnormality secondary to the infection. SPECT scans of the brain might provide an objective measure of abnormalities present in patients with otherwise difficult to objectify clinical findings. The objective of this study was to determine the frequency, location, and severity of abnormalities in SPECT scans of the brain of patients with chronic Lyme disease.

Methods: A total of 183individuals who met the clinical definition of chronic Lyme disease underwent SPECT scanning of the brain using 99mTc and standard nuclear imagine techniques. Abnormalities of perfusion to affected areas of the brain were defined as mild, moderate, or severe.

Results: Of all patients, 75% demonstrated abnormalities in perfusion to various areas of the brain, most notably the frontal, temporal, and parietal lobes. Patients considered to be seropositive and those considered seronegative had similar rates, types, and severity of perfusion defects. Abnormalities of MRI of the brain were seen in 14% of patients. Treatment with antibiotics, especially those with intracellular-penetrating activity, resulted in resolution or improvement of abnormalities in 70% of patients over a 1- to 2-year period.

Conclusions: Brain SPECT scans are abnormal in most patients with chronic Lyme disease, and these scans can be used to provide objective evidence in support of the clinical diagnosis. The use of certain antibiotic regimens seems to provide improvement in both clinical status and SPECT scans.

http://journals.lww.com/nuclearmed/...Brain_Imaging_in_Chronic_Lyme_Disease.33.aspx

 

[RustyJ]

I had these exact Spect scan results more than 15 years ago. https://www.facebook.com/pages/XMRV-Global-Action/216740433250

Does anyone know whose patients these were? I'd love to know what antibiotic regimes they were on.

 

[Enid]

Thanks for this information RustyJ - I had what were described as "high spots" on my own MRI brain scan which my Neurologist never resolved so watching your thread here with much interest.

 

[Gamboa]

Very interesting. I had a SPEC scan done a month ago but don't have results yet since my doctor is on holiday.

Thanks for posting.

 

[GracieJ]

Someday we will see a decent study with ME/CFS and SPECT. I follow Dr. Daniel Amen and his SPECT work quite closely. Maybe he is one we could approach.

 

[justinreilly]

Rusty,

I have Lyme, so found this very interesting. (this thread should actually be moved to the Other Health News and Research part of the forum - you can contact an admin to get this done)

 

[heapsreal]

I had these exact Spect scan results more than 15 years ago. https://www.facebook.com/pages/XMRV-Global-Action/216740433250

Does anyone know whose patients these were? I'd love to know what antibiotic regimes they were on.

I think most lyme treatments revolve around doxycycline and azithromycin. These 2 antibiotics are the most helpful in cfs patients as well for different bacterial infections too.

 

[SilverbladeTE]

As said, they wouldn 't do follow up MRI or SPECT scans on me, despite pituitary issues, lesions etc :/

 

[vitamink]

i had an abnormal spect scan recently and the results were typical of lyme disease. i'm starting i.v. antibiotics (rocephin and possibly rifampin) tomorrow...

 

[RustyJ]

Without the benefit of reading the full study, I think the significance of this study is that it offers a good means of quantifying the progress of treating lyme (and me/cfs) with antibiotics.

I don't think the scans provide lyme or me/cfs causality (abnormal perfusion etc could be caused by another pathogen altogether, perhaps even an opportunistic pathogen), but they do prove quantifiable physical changes to be achieved by using antibiotics for a large proportion of those with an me/cfs or lyme diagnosis.

The significance of this for me/cfs? Irrespective of the cause of me/cfs, many of those who have been diagnosed with me/cfs may also receive a diagnosis of lyme, and vice versa. We are not talking about a small cohort here, but something in the nature of about 75% from at least one previous study.

There is as yet no indication the improvements are permanent, which would support the notion that the brain abnormalities were caused by the primary agent or pathogen.

 

[RustyJ]

i had an abnormal spect scan recently and the results were typical of lyme disease. i'm starting i.v. antibiotics (rocephin and possibly rifampin) tomorrow...

Good luck.

 

[redo]

In my eyes, this work marks the beginning of a paradigm shift. Up until now, the conservative establishment recites again and again Klempner et al. and other similar works and saying that «antibiotics» don't help people with «Post Lyme Disease». The problem with those old studies is that they only use doxycycline and ceftriaxon in moderate doses, so the only thing which can be concluded from the old studies is that doxycycline and ceftriaxon in moderate doses doesn't help.

Other antibiotics, such as biaxin, have been immensely important at relieving the symptoms of those who are ill. If you take a look at the symptoms of «Post Lyme Disease», also called chronic lyme disease, and it gets even more interesting. They are symptoms many of us are all too familiar with. Here are parts of them:

• Fatigue, tired, poor stamina
• Confusion, difficulty thinking
• Difficulty with concentration, reading, problem absorbing new information
• Word search, name block
• Speech errors- wrong word, misspeaking
• Forgetfulness, poor short term memory, poor attention
• Insomnia, fractionated sleep
• Joint pain
• Exaggerated symptoms or worse hangover from alcohol
• Unexplained back pain
• Fevers
• Disorientation: getting lost
• Light sensitivity
• Sound sensitivity
• Sore soles, esp. in the AM
• Sore throat
• Vision: double, blurry, floaters
• Mood swings, irritability
• Muscle pain or cramps
• Increased motion sickness
• Vertigo, spinning
• Off balance, “tippy” feeling
• Tingling, numbness, burning or stabbing sensations

And what makes it even more intriguing is that in chronic cases, the consensus accepted by most physicians (on this highly controversial topic) is that the original infection is gone, but the patient is still sick. So, IMO, lyme disease is to the symptoms above (read ME), the same as giardiasis is to ME, or as mononucleosis is to ME. So, various triggers lead to the same result.

What we can take from this, is that the treatments which help (but doesn't cure) the cases of chronic lyme disease (CLD) have good potential of helping many whom have ME. That said the treatment of CLD doesn't help all of those with CLD, but for many it makes the life livable again.

I really do think that the crucial question in the time to come, for «Post Lyme Disease»/CLD would be why does antibiotics help, rather than if antibiotics help. What I except the answer to that question is, is that it helps with other things than curing a bacterial infection they can't prove for certain is there (read lyme disese). I find it more likely that they'll find out that the antibiotics help because they have immune modulating properties (most patients get worse pretty quickly when they are without antibiotics), or it affects a harmful gut flora (just like it's known that a harmful flora in the mouth causes problems, I find it likely that something similar will be found with regards to the gut) and it may have really unexpected effects such as having some antiviral properties (it's established for sure that many antibiotics do).

 

[justinreilly]

Redo,

You know more on Lyme than I, but my understanding is that the Lyme bacterium my persist in people with chronic Lyme, it is just harder to detect and thus mainstream science assumes its not there.

I found out I have Lyme a few months ago after 10years of illness. I suggest everyone with ME get a good Lyme test like the one I took from Igenex. CDC says its test is 100% accurate and warns against taking PCR tests, but CDCs test actually misses 40% of cases and the PCR test is better though not perfect.

 

[redo]

Thank you for your reply justinreilly.

Although I wouldn't mind if a live bacteria would be the problem, I think there's too many ifs and buts that it all adds up.

With the PCR technique they can't find the bacteria in chronic cases on a reliable basic. Nor with the standard antibody tests. When treating for CLD for years and years, people get better (but rarely well) and often times relapse once the antibiotics are lifted - indicating immune modulation or other mechanisms rather than antibacterial activity.

I think there are slight chances that because of mechanisms such as hiding in biofilms and going into cyst phases, there is a chance, albeit small, that a persisting bacteria is the problem. But given the symptoms being pretty much identical with those of ME, and also the sum of small and large observations from within the lyme world for almost a decade, I'd really put my chips on lyme being just another trigger to ME, just like giardisis, just like mononucleosis. The big question is what gets triggered. If it indeed is a RNA virus, then the virus must lie latent in many healthy people, and burst out once the trigger sets it off. Which in turn would have implications for the RNA virus studies, since the most likely outcome, if it indeed is a RNA virus at the core of this, is that it's prevalent also in the healthy controls.

That said, many if not most who embark on a treatment course for CLD gets better. In the Donta study which this article is about, they didn't exclude people with CFS from the study. If someone has excess energy to do it, then asking Donta if the patients with CFS in his study improved like the rest would be a good and useful question.

I have been on lyme treatment for years, and it has really turned so much to the better, so if anyone feels for doing the same, I'd think it's a good idea. At the same time, I wouldn't be so certain that it's actually the lyme bacteria which gets treated, and it rather be that it's immunemodulating effects, either directly or through influences on levels of various bacteria in the flora of the gut - or other mechanisms. Little is known about why they work, and hopefully this study will spark interest to find out why.

The fact that there weren't any differences in how the seronegative and seropositive reacted also fits into the picture of this perhaps not being a live bacteria, but rather «something» has been triggered by the borrelia infection.

 

[Wally]

Here is an abstract of a study from 1982 that discusses the antiviral activity found in antibiotic producing marine bacteria. The authors of this study are Alicia E. Toranzo, Juan L. Barja, Frank M. Hetrick and it was published in the Canadian Journal of Microbiology, 1982, 28(2): 231-238, 10.1139/m82-031.

"The stability of poliovirus 1 in estuarine water and sediment was examined. The present data indicated that a 2 log reduction in virus titer at 15 °C occurred within 6–7 days in water samples taken from estuarine waters on both sides of the Atlantic Ocean. The antiviral effect decreased significantly when the seawater was subjected to autoclaving but not when it was filtered. That the antiviral activity of the seawater was related to the growth activities of microorganisms was corroborated by the isolation of antibiotic-producing marine bacteria that had marked activity against poliovirus (net inactivation ≥ 2 logs within 6–8 days). These organisms retained this activity following repeated subcultivation on laboratory media. Since comparable inactivation rates were observed in cell-free filtrates from these marine strains, extracellular products appear to be involved in the virus-inactivation process. Other enteric viruses, Coxsackie B-5 and ECHO-6, were also inactivated by these marine bacteria. The addition of sediment to natural seawater increased the length of poliovirus survival more than three times over that in seawater alone. However, this was not found under sterile conditions, suggesting that the sediment can protect the viruses from inactivation by the marine microflora."
http://www.nrcresearchpress.com/doi/abs/10.1139/m82-031?journalCode=cjm#citart1

Can antibiotic producing marine bacteria also produce antiviral properties? If yes, isn't it possible for certain antibiotics to also have some type of antiviral action?

 

[xks201]

If the bacteria is not doing it the inflammation is...

 

[redo]

Here's some good news on a Friday.

In the full text of the study it says the following (my bolds, the excerpts have large bulks of text cut out between them, as I didn't want to paste the whole study in the thread):

METHODS
Patients were considered to have chronic Lyme disease if they lived or were exposed to deer ticks in an endemic area for Lyme disease and had symptoms (2/3) of otherwise unexplained fatigue, musculoskeletal pain, and/or neurocognitive dysfunction persisting for more than 6 months, a definition similar to that of chronic fatigue syndrome. Patients given the diagnosis of chronic fatigue syndrome or fibromyalgia were not excluded from the analyses.

Most patients were treated with courses of intracellularpenetrating antibiotics, either tetracycline itself, 1500 mg/d, or the combination of clarithromycin (1000 mg/d) and hydroxychloroquine (400 mg/d) over at least a 3-month period, usually 6 months - a regimen that seems to result in resolution of sustainable improvement in patient symptoms.

RESULTS
Seventy percent of treated patients with abnormalities on the SPECT scans of their brains showed improvement or clearing of all perfusion defects after antibiotic treatment of their chronic Lyme disease (Table 3). Compared with untreated patients (16/88, 18%), patients treated with intracellular-penetrating antibiotics, that is, tetracycline (8/19, 42%), or the combination of clarithromycin and hydroxychloroquine (8/11, 72%) had greater normalization of their scans than did patients treated with IV ceftriaxone (4/26, 15%) or other A-lactam antibiotics (eg, oral amoxicillin) or doxycycline (10/38, 26%; data not shown).


A friend of have been in touch with the scientist behind the study, to ask if the people whom had a ME diagnosis responded any different to treatment than the rest - and the answer was that both groups had the same results. The patients subjectively reports alleviation of symptoms, along with the SPECT scans getting better.

Although a long shot for many, I think there's much to gain and little to risk on such trials. Especially if one has a SPECT scan showing abnormalities, or if one lives in where ticks are widespread.

 

[RustyJ]

Here's some good news on a Friday.

In the full text of the study it says the following (my bolds, the excerpts have large bulks of text cut out between them, as I didn't want to paste the whole study in the thread):

METHODS
Patients were considered to have chronic Lyme disease if they lived or were exposed to deer ticks in an endemic area for Lyme disease and had symptoms (2/3) of otherwise unexplained fatigue, musculoskeletal pain, and/or neurocognitive dysfunction persisting for more than 6 months, a definition similar to that of chronic fatigue syndrome. Patients given the diagnosis of chronic fatigue syndrome or fibromyalgia were not excluded from the analyses.

Most patients were treated with courses of intracellularpenetrating antibiotics, either tetracycline itself, 1500 mg/d, or the combination of clarithromycin (1000 mg/d) and hydroxychloroquine (400 mg/d) over at least a 3-month period, usually 6 months - a regimen that seems to result in resolution of sustainable improvement in patient symptoms.

RESULTS
Seventy percent of treated patients with abnormalities on the SPECT scans of their brains showed improvement or clearing of all perfusion defects after antibiotic treatment of their chronic Lyme disease (Table 3). Compared with untreated patients (16/88, 18%), patients treated with intracellular-penetrating antibiotics, that is, tetracycline (8/19, 42%), or the combination of clarithromycin and hydroxychloroquine (8/11, 72%) had greater normalization of their scans than did patients treated with IV ceftriaxone (4/26, 15%) or other A-lactam antibiotics (eg, oral amoxicillin) or doxycycline (10/38, 26%; data not shown).


A friend of have been in touch with the scientist behind the study, to ask if the people whom had a ME diagnosis responded any different to treatment than the rest - and the answer was that both groups had the same results. The patients subjectively reports alleviation of symptoms, along with the SPECT scans getting better.

Although a long shot for many, I think there's much to gain and little to risk on such trials. Especially if one has a SPECT scan showing abnormalities, or if one lives in where ticks are widespread.

This is brilliant. I have spect scans showing perfusion and have had tick associations. I have found a lyme doctor in Noosaville and will use this paper to push for this treatment regime.

 

[RustyJ]

RESULTS
Seventy percent of treated patients with abnormalities on the SPECT scans of their brains showed improvement or clearing of all perfusion defects after antibiotic treatment of their chronic Lyme disease (Table 3). Compared with untreated patients (16/88, 18%), patients treated with intracellular-penetrating antibiotics, that is, tetracycline (8/19, 42%), or the combination of clarithromycin and hydroxychloroquine (8/11, 72%) had greater normalization of their scans than did patients treated with IV ceftriaxone (4/26, 15%) or other A-lactam antibiotics (eg, oral amoxicillin) or doxycycline (10/38, 26%; data not shown).

Hi redo, any chance there were details of the successful regime: dosages etc? Better yet could you PM me the full paper?

 

[Jacque]

Wow I clicked on this thread and had NO idea it was about Lyme... As I read through all of these posts I just become so ANGRY, SAD and every other emotion! We are all like rats running around in a maze tryin to find the cheese...we know it is there - but we just can't find it because there are no signs or directions!! We are all SICK and want so badly to get well and spend HOURS on these dang computers searching throught the piles of info trying to find out why we are sick.

I feel for everyone of you... I am one of you.. I have been sick for 35 years... I link it to a terrrrrible flu like illness when I was around 12 - which coincidentally is about a time in my life where I had a tick burrowed into my eardrum long enuf to block the canal and not allow me to hear in that ear... My mom backed it out with a match (BAD)... At 18 I was told I had Rheum. Arth and had positive RA factor for 5 years then it went negative altho the pain, fatigue, no sleep, and cognitive persisted!! Later diagnosed with EBV/CFS/FM/Lupus/Hashimotos/Chiari Malformation. My Igenex Lyme tests show negative altho 6 of the bands were positive. I have had Lyme sooo long none of the tests can pick it up accurately. I am confident I DO have Lyme...bc every time I take an antibiotic or natural lyme killer my body goes into severe Herxheimer reaction...that is all I need to know.

I have also been diagnosed with Bio Toxin illness and the dreaded HLA profile, which is why I cannot tolerate any of the treatments for Lyme. My body cannot get rid of the Bio Toxins.

Dr. Gonzales says I have Chronic Lyme, Dr. Shoemaker in MD - Bio Toxin Illness, Dr. Kogelnik ME/CVID...none of them can agree with what is wrong with me... Which has made me want to add a new doc to the list... A PSYCHIATRIST... but I do not have the funds for that!

Have you all watched UNDER OUR SKIN??? It is on Netflix - you all should watch it...it is exactly what you are all talking about here... It leans toward the theory that Lyme is at the CORE of all of these Autoimmune Disease "labels" CFS, ME, Fibro, Lupus, ALS, MS, etc... I have done extensive research on Lyme and the more you read about it the scarier it becomes... especially when you read about the "manmade" kind that literally has its own intelligence... Can morph, change shapes, etc...tricks the immune system into a tizzy...creating severe inflammation due to the immune system tryin to get at it...

I have not had a spect scan done... My other question for all of you is... Have any of you read Betrayal of the Brain? It would be a great read as it explains that when we are infected with ?? ?? it damages the hypothalamus/pituitary which is in this doc's opinion what causes CFS, FM...etc... Yet ANOTHER theory...

Where is my SHRINK????? lol I will be following this thread to see how you all do...

I hope you can tolerate the abx better than I... I curl up in a ball, want to die, and become extremely suicidal bc my brain swells (more)... Please keep us posted how you do...

I have a girlfriend with Chronic Lyme who did a long round of IV Rocehpin etc...and got better and was in remission...and then WHAM.... it came back... she just did another 4 month round and is better and in remission again... Will see how this time goes with her... She has spent thousssssssands! bc Insurance does not cover her Abx.

My doc Dr. Kogelnik commented to me that I could have gotten all of my Viral infections from the tick bite as well...So maybe someday they will find that it is not just the Borrelia makin people sick with Lyme but that some with ME get the viral infections???

I am currently on Rituxan to try to get the HHV6, EBV, HSV1 and 2 under control.... Time will tell.

Fight on Warriors!! Lets find the cheese!