Standardized Symptom Measurement of Individuals with Early Lyme Disease Over Time

Arch Clin Neuropsychol. 2017 Mar 1;32(2):129-141. doi: 10.1093/arclin/acw098.


Objective: Understanding the Lyme disease (LD) literature is challenging given the lack of consistent methodology and standardized measurement of symptoms and the impact on functioning. This prospective study incorporates well-validated measures to capture the symptom picture of individuals with early LD from time of diagnosis through 6-months post-treatment.

Method: One hundred seven patients with confirmed early LD and 26 healthy controls were evaluated using standardized instruments for pain, fatigue, depressive symptoms, functional impact, and cognitive functioning.

Results: Prior to antibiotic treatment, patients experience notable symptoms of fatigue and pain statistically higher than controls. After treatment, there are no group differences, suggesting that symptoms resolve and that there are no residual cognitive impairments at the level of group analysis. However, using subgroup analyses, some individuals experience persistent symptoms that lead to functional decline and these individuals can be identified immediately post-completion of standard antibiotic treatment using well-validated symptom measures.

Conclusions: Overall, the findings suggest that ideally-treated early LD patients recover well and experience symptom resolution over time, though a small subgroup continue to suffer with symptoms that lead to functional decline. The authors discuss use of standardized instruments for identification of individuals who warrant further clinical follow-up.

Keywords: Cognitive impairment; Fatigue; Lyme disease; Post-treatment Lyme disease syndrome; Symptom measurement.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Cognition Disorders / drug therapy
  • Cohort Studies
  • Doxycycline / therapeutic use*
  • Fatigue / drug therapy
  • Fatigue / etiology
  • Female
  • Humans
  • Lyme Disease* / diagnosis
  • Lyme Disease* / drug therapy
  • Lyme Disease* / physiopathology
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Outcome Assessment, Health Care / methods*
  • Outcome Assessment, Health Care / standards*
  • Pain / drug therapy
  • Pain / etiology
  • Psychiatric Status Rating Scales
  • Self Report
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome*
  • Young Adult


  • Anti-Bacterial Agents
  • Doxycycline