COGNITIVE EFFECTS OF LYME-DISEASE IN CHILDREN

Objective. To measure possible cognitive sequelae of Lyme disease (LD) within a pediatric population. Design. Prospective, blinded, controlled study of cognitive skills in children who had been treated for LD. Setting. A children's hospital in an area endemic for LD. Patients. Forty-one children with strictly defined LD were compared with 14 control children who had subacute rheumatological diseases, and with 23 healthy sibling controls. Outcome measures. Neuropsychologic measures were administered to each child to assess the following cognitive areas: IQ, information processing speed, fine-motor dexterity, novel-problem solving and executive functioning, short-term and intermediate memory, and the ability to acquire new learning. Predisease and postdisease academic achievement test scores were also gathered. Impressions from parents concerning the disease's subsequent impact were also obtained. Results. No differences between LD and control groups were found for any of the numerous neuropsychologic measures. Analyses also failed to show differences between LD patients grouped with respect to the presence or absence of known neurologic involvement, disease stage, duration of symptoms before therapy, or type of antibiotic treatment. No predisease versus postdisease difference in academic performance was found. No perceived long-term deterioration in cognitive, social, or personality areas was reported by parents. Conclusion. Children appropriately treated for LD have an excellent prognosis for unimpaired cognitive functioning.