ArticlePloS one2019
Association of small fiber neuropathy and post treatment Lyme disease syndrome.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 33 citations in OpenAlex.
- Autonomic Dysfunction in Patients withPathogens (Basel, Switzerland) · 2026Article
- Infection-Triggered Immune Dysregulation and Immunopathology in Lyme Disease: Mechanisms and Clinical Implications.Journal of clinical medicine · 2026Review
- Epidemiology, diagnosis and emerging therapies for Lyme disease of the Northern Hemisphere.International journal of emergency medicine · 2026Review
- Autonomic Dysfunction in Patients with Acute Infection withPathogens (Basel, Switzerland) · 2025Article
- Autonomic Symptoms in Post-Treatment Lyme Disease: Insights From the COMPASS-31 and the 10-Minute Active Stand Test.Mayo Clinic proceedings. Innovations, quality & outcomes · 2025Article
- Small-Fiber Neuropathy: An Etiology-Oriented Review.Brain sciences · 2025Review
- Article
- Acute Febrile Illness Accompanied by 7th and 12th Cranial Nerve Palsy Due to Lyme Disease Following Travel to Rural Ecuador: A Case Report and Mini-Review.Tropical medicine and infectious disease · 2025Article
- The relationship between cardiovagal baroreflex and cerebral autoregulation in postural orthostatic tachycardia disorder using advanced cross-correlation function.Scientific reports · 2024Article
- Fibroblast growth factor receptor inhibitors mitigate the neuropathogenicity ofFrontiers in immunology · 2024Article
- Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?Frontiers in neurology · 2024Review
- Posttreatment Lyme disease syndrome and myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and comparison of pathogenesis.Chronic diseases and translational medicine · 2023Review
- Neuropsychiatric Lyme Disease and Vagus Nerve Stimulation.Antibiotics (Basel, Switzerland) · 2023Review
- Neuropsychiatric Symptoms and Tick-Borne Diseases.Current topics in behavioral neurosciences · 2023Article
- Observational case-control study of small-fiber neuropathies, with regards on smoking and vitamin D deficiency and other possible causes.Frontiers in medicine · 2022Article
- Lyme Neuroborreliosis: Mechanisms ofBrain sciences · 2021Review
- Current View of Diagnosing Small Fiber Neuropathy.Journal of neuromuscular diseases · 2021Review
- Post COVID-19 syndrome associated with orthostatic cerebral hypoperfusion syndrome, small fiber neuropathy and benefit of immunotherapy: a case report.eNeurologicalSci · 2020Article
- A Practical Approach to the Diagnosis of Lyme Borreliosis: From Clinical Heterogeneity to Laboratory Methods.Frontiers in medicine · 2020Review
- Symptom Clusters and Functional Impairment in Individuals Treated for Lyme Borreliosis.Frontiers in medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine whether post-treatment Lyme disease syndrome (PTLDS) defined by fatigue, cognitive complaints and widespread pain following the treatment of Lyme disease is associated with small fiber neuropathy (SFN) manifesting as autonomic and sensory dysfunction.
methodsThis single center, retrospective study evaluated subjects with PTLDS. Skin biopsies for assessment of epidermal nerve fiber density (ENFD), sweat gland nerve fiber density (SGNFD) and functional autonomic testing (deep breathing, Valsalva maneuver and tilt test) were performed to assess SFN, severity of dysautonomia and cerebral blood flow abnormalities. Heart rate, end tidal CO2, blood pressure, and cerebral blood flow velocity (CBFv) from middle cerebral artery using transcranial Doppler were monitored.
results10 participants, 5/5 women/men, age 51.3 ± 14.7 years, BMI 27.6 ± 7.3 were analyzed. All participants were positive for Lyme infection by CDC criteria. At least one skin biopsy was abnormal in all ten participants. Abnormal ENFD was found in 9 participants, abnormal SGNFD in 5 participants, and both abnormal ENFD and SGNFD were detected in 4 participants. Parasympathetic failure was found in 7 participants and mild or moderate sympathetic adrenergic failure in all participants. Abnormal total CBFv score was found in all ten participants. Low orthostatic CBFv was found in 7 participants, three additional participants had abnormally reduced supine CBFv.
conclusionsSFN appears to be associated with PTLDS and may be responsible for certain sensory symptoms. In addition, dysautonomia related to SFN and abnormal CBFv also seem to be linked to PTLDS. Reduced orthostatic CBFv can be associated with cerebral hypoperfusion and may lead to cognitive dysfunction. Autonomic failure detected in PTLDS is mild to moderate. SFN evaluation may be useful in PTLDS.
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