What Do We Need to Know About It

As a diagnosed disease, Lyme is still in its infancy. While we have learned a great deal about it over the past few decades, there is still a great deal we need to learn in order to better understand the disease and to devise appropriate treatments.

Among the many questions that need to be answered are: brain

1. When the brain and nerves become involved?

2. How long do the brain and nerves stay involved?

3. Is infection the trigger, and if so, does the immune system perpetuate it?

4. When patients endure "disabling times," involving encephalopathy, cognitive issues, psychological or psychiatric problems, etc., what is the cause?

5. How should the appropriate course of treatment be determined?

6. Some patients require differing durations of antibiotic treatment. Are there predictors that can determine why some patients require different durations?

7. How early do we need to intervene in order to increase chances for successful outcomes?

8. Are there special issues related to the age of the patient, especially at the ends of the age spectrum (i.e., in children and in the elderly)?

9. What role, if any, does Lyme play in "look-alike" disorders (e.g., multiple sclerosis, Lou Gehrig's, Parkinson and even Alzheimer's disease)?

10. How early do neurological problems actually occur, and what determines their onset?

The trials that we are currently underway will contribute to the fund of knowledge surrounding some of these "big questions." For example, "An Animal Model of Human Lyme Disease with Emphasis on the Brain" hopes to examine how long it takes injected Borrelion spirochetes into the skin to reach the brain in experimental animals. Another study, "MR Imaging (MRI) and Proton Spectroscopy (1H-MRS) Coupled with Whole Brain N-acetyl-asparatate (NAA) In Lyme Disease," seeks to use the most powerful imaging techniques to not only find lesions in the brain but to provide a more complete picture of brain function and structure in Lyme disease. A third study, "A Clinical Trial of the role of SDF1- α And CXCR4 In Lyme Disease," looks at cerebrospinal fluid, which can be non-specific in its abnormalities, but will help us understand how certain factors influence Lyme's effect on the nervous system.

There is a great deal that needs to be learned about Lyme disease. Fortunately, we have a solid base of existing knowledge upon which to build, and that base will only become strengthened by the results of current and future studies.