Are white matter hyperintensities associated with neuroborreliosis? The answer is twofold

Many consider white matter hyperintensities (WMHs) to be important imaging findings in neuroborreliosis. However, evidence regarding association with WMHs is of low quality. The objective was to investigate WMHs in neuroborreliosis visually and quantitatively. Patients underwent brain MRI within one...

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Bibliographic Details
Published in:	Neuroradiology
Main Authors:	Lindland, Elisabeth S, Røvang, Martin S, Solheim, Anne Marit, Andreassen, Silje, Skarstein, Ingerid, Dareez, Nazeer, MacIntosh, Bradley J, Eikeland, Randi, Ljøstad, Unn, Mygland, Åse, Bos, Steffan D, Ulvestad, Elling, Reiso, Harald, Lorentzen, Åslaug R, Harbo, Hanne F, Bjørnerud, Atle, Beyer, Mona K
Format:	Journal Article
Language:	English
Published:	Germany 18-10-2024
Subjects:	Lyme neuroborreliosis Magnetic resonance imaging Central nervous system infections Tick-borne diseases
Online Access:	Get full text
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Summary:	Many consider white matter hyperintensities (WMHs) to be important imaging findings in neuroborreliosis. However, evidence regarding association with WMHs is of low quality. The objective was to investigate WMHs in neuroborreliosis visually and quantitatively. Patients underwent brain MRI within one month of diagnosis and six months after treatment. Healthy controls were recruited. WMHs were counted by visual rating and the volume was calculated from automatic segmentation. Biochemical markers and scores for clinical symptoms and findings were used to explore association with longitudinal volume change of WMHs. The study included 74 patients (37 males) with early neuroborreliosis and 65 controls (30 males). Mean age (standard deviation) was 57.4 (13.5) and 57.7 (12.9) years, respectively. Baseline WMH lesion count was zero in 14 patients/16 controls, < 10 in 36/31, 10-20 in 9/7 and > 20 in 13/11, with no difference between groups (p = 0.90). However, from baseline to follow-up the patients had a small reduction in WMH volume and the controls a small increase, median difference 0.136 (95% confidence interval 0.051-0.251) ml. In patients, volume change was not associated with biochemical or clinical markers, but with degree of WMHs (p values 0.002-0.01). WMH lesions were not more numerous in patients with neuroborreliosis compared to healthy controls. However, there was a small reduction of WMH volume from baseline to follow-up among patients, which was associated with higher baseline WMH severity, but not with disease burden or outcome. Overall, non-specific WMHs should not be considered suggestive of neuroborreliosis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0028-3940 1432-1920 1432-1920
DOI:	10.1007/s00234-024-03482-0