Kaplan R F, Meadows M E, Vincent L C, Logigian E L, Steere A C
Department of Neurology, Tufts University School of Medicine, New England Medical Center, Boston, MA 02111.
Neurology. 1992 Jul;42(7):1263-7. doi: 10.1212/wnl.42.7.1263.
Lyme encephalopathy, primarily manifested by disturbances in memory, mood, and sleep, is a common late neurologic manifestation of Lyme disease. We compared 20 patients with Lyme encephalopathy with 11 fibromyalgia patients and 11 nonpsychotically depressed patients using the California Verbal Learning Test, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Minnesota Multiphasic Personality Inventory (MMPI), and Beck Depression Inventory. Compared with patients with fibromyalgia or depression, the Lyme encephalopathy group showed mild, but statistically significant, memory deficits on two of the three memory tests. In contrast, the patients with fibromyalgia scored significantly higher than both other groups on the MMPI scale most sensitive to somatic concerns (scale 1), while the depressed patients scored higher than the Lyme patients on the scales most sensitive to depression (scale 2) and anxiety (scale 7). Physical complaints and depression were not major factors in memory performance among Lyme patients. These data support the hypothesis that Lyme encephalopathy is caused by CNS dysfunction and cannot be explained as a psychological response to chronic illness.
莱姆病性脑病主要表现为记忆、情绪和睡眠障碍，是莱姆病常见的晚期神经表现。我们使用加利福尼亚言语学习测验、韦氏记忆量表、雷-奥斯特里思复杂图形测验、明尼苏达多相人格调查表（MMPI）和贝克抑郁量表，将20例莱姆病性脑病患者与11例纤维肌痛患者及11例非精神病性抑郁症患者进行了比较。与纤维肌痛或抑郁症患者相比，莱姆病性脑病组在三项记忆测试中的两项上表现出轻度但具有统计学意义的记忆缺陷。相比之下，纤维肌痛患者在MMPI中对躯体问题最敏感的量表（量表1）上的得分显著高于其他两组，而抑郁症患者在对抑郁（量表2）和焦虑（量表7）最敏感的量表上的得分高于莱姆病患者。身体不适和抑郁并非莱姆病患者记忆表现的主要因素。这些数据支持了莱姆病性脑病是由中枢神经系统功能障碍引起的这一假说，而不能解释为对慢性疾病的心理反应。
