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Med Mal Infect. 2019 Feb 5. pii: S0399-077X(18)30677-2. doi: 10.1016/j.medmal.2019.01.002. [Epub ahead of print]

Functional neuroimaging in patients presenting with somatoform disorders: A model for investigating persisting symptoms after tick bites and post-treatment Lyme disease syndrome?

Author information

1
Service de médecine nucléaire, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France; CERIMED, Aix-Marseille université, 13005 Marseille, France; CNRS, centrale Marseille, institut Fresnel, Aix-Marseille université, 13005 Marseille, France.
2
SSA, VITROME, IHU méditerranée infection, IRD, Aix-Marseille université, AP-HM, 13005 Marseille, France.
3
MEPHI, IRD, IHU méditerranée infection, Aix-Marseille université, AP-HM, 19-21, boulevard Jean-Moulin, 13385 Marseille cedex 05, France. Electronic address: didier.raoult@gmail.com.
4
Clinique l'Émeraude, 34, traverse de La Seigneurie, 13009 Marseille, France.
5
Institut de neurosciences de la Timone UMR7289, campus santé, Aix-Marseille université, 13005 Marseille, France; Pôle de psychiatrie, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France; Fondation FondaMental, 13005 Créteil, France.

Abstract

Approximately 10% of patients presenting with Lyme disease experience fatigue, musculoskeletal pain, concentration disorders, or short-term memory deficits in the six months following treatment. This entity has been defined as post-Lyme disease syndrome or post-treatment Lyme disease syndrome. The pathophysiology of this syndrome is unknown, but neither persistence of the bacterium nor effectiveness of antibiotics are currently reported in the literature. The French High Council for Public Health (French acronym HCSP) has recently defined a new entity called "persistent polymorphic symptoms after a tick bite" allowing for designing studies to better understand these subjective presentations, for which objective biomarkers are currently lacking. This entity encompasses patients experiencing fatigue and generalized pain in the months following a tick bite and can be associated with several subjective symptoms with major impact on the quality of life. In the field of somatoform disorders, this article reviews functional neuroimaging studies in patients presenting with subjective complaints and discusses potential clinical implications for persisting symptoms after tick bites and post-treatment Lyme disease syndrome.

KEYWORDS:

Chronic Lyme; Conversion disorder; Fibromyalgia; Fibromyalgie; Imagerie moléculaire; Lyme chronique; Molecular imaging; Somatoform disorder; Trouble dissociatif; Trouble somatoforme

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