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Trial Lecture – time and place
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Adjudication committee
- First opponent: Assistant Professor Paolo Preziosa, Vita-Salute San Raffaele University, Italy
- Second opponent: Professor Eli Renate Grüner, University of Bergen
- Third member and chair of the evaluation committee: Professor II Anne Margarita Dyrhol Riise, University of Oslo
Chair of the Defence
Professor II Harriet Akre, University of Oslo
Principal Supervisor
Professor II Mona Kristiansen Beyer, University of Oslo
Summary
Neuroborreliosis is caused by spread of Borrelia burgdorferi bacteriae to the nervous system after a tick bite. Many worry about continuation of symptoms such as fatigue, pain and cognitive complaints after treatment. Previous studies have limited use of systematic and quantitative image evaluation. Consequently, typical imaging findings of neuroborreliosis are underreported, and association with white matter lesions is overstated.
In this thesis, brain MRI data from a prospective, longitudinal case-control study were investigated as biomarkers for diagnosis and prognosis in neuroborreliosis. The aims were to assess frequency of cranial nerve contrast enhancement, compare occurrence of white matter hyperintense lesions with healthy controls, and study blood-brain barrier leakage in selected brain regions.
More than half of patients had contrast enhancement of cranial nerves in the early disease phase. Signs of brain inflammation were rare, and there were no more white matter lesions in patients than controls by visual assessment. However, advanced and quantitative imaging methods showed that longitudinal change of white matter hyperintensities and blood-brain barrier function was different in patients compared to healthy controls. No association was found between the imaging markers and fatigue or neuropsychological tests.
The study provided new insight to neuroborreliosis pathophysiology, and identified enhancement of the facial nerve parotid segment as a potential imaging marker for increased risk of persistent facial palsy.
Additional information
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