title: Immunologic reactivity against Borrelia burgdorferi in patients with motor neuron disease.
abstract: Of 19 unselected patients with the diagnosis of amyotrophic lateral sclerosis (ALS) living in Suffolk County, New York (an area of high Lyme disease prevalence), 9 had serologic evidence of exposure to Borrelia burgdorferi; 4 of 38 matched controls were seropositive. Eight of 9 seropositive patients were male (8 of 12 male patients vs 2 of 24 controls). Rates of seropositivity were lower among patients with ALS from nonendemic areas. All patients had typical ALS; none had typical Lyme disease. Cerebrospinal fluid was examined in 24 ALS patients--3 (all with severe bulbar involvement) appeared to have intrathecal synthesis of anti-B burgdorferi antibody. Following therapy with antibiotics, 3 patients with predominantly lower motor neuron abnormalities appeared to improve, 3 with severe bulbar dysfunction deteriorated rapidly, and all others appeared unaffected. There appears to be a statistically significant association between ALS and immunoreactivity to B burgdorferi, at least among men living in hyperendemic areas.
authors.affiliation: Department of Neurology, State University of New York, Stony Brook 11794.
authors.forename: J J
authors.initials: JJ
authors.lastname: Halperin
authors.forename: G P
authors.initials: GP
authors.lastname: Kaplan
authors.forename: S
authors.initials: S
authors.lastname: Brazinsky
authors.forename: T F
authors.initials: TF
authors.lastname: Tsai
authors.forename: T
authors.initials: T
authors.lastname: Cheng
authors.forename: A
authors.initials: A
authors.lastname: Ironside
authors.forename: P
authors.initials: P
authors.lastname: Wu
authors.forename: J
authors.initials: J
authors.lastname: Delfiner
authors.forename: M
authors.initials: M
authors.lastname: Golightly
authors.forename: R H
authors.initials: RH
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000276:immunology; D000907:Antibodies, Bacterial / Q000032:analysis*; D000914:Antibodies, Viral / Q000032:analysis; D015748:Borrelia burgdorferi Group / Q000276:immunology*; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons; D009132:Muscles / Q000503:physiopathology; D009420:Nervous System / Q000503:physiopathology; D009422:Nervous System Diseases / Q000276:immunology; D009468:Neuromuscular Diseases / Q000276:immunology* / Q000503:physiopathology; D012016:Reference Values
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral