Journal: Brain Stimulation (2018)
Authors: Sheth M, Inamdar S, Karkhanehchin N, Roach B, Walsh M, Dehart A
Background:
Late stages of Lyme disease include cognitive impairment, such as memory loss, slowed handling of information and substandard abstract reasoning. High frequency deep transcranial magnetic stimulation (dTMS) over the left prefrontal cortex (lPFC) has been shown to improve cognitive functioning for patients with negative and cognitive symptoms of schizophrenia. The authors treated a depressed patient six years after diagnosis of Lyme disease with ongoing depression and cognitive slowing.
Objective:
To report potential efficacy in improving cognitive impairment found in patients with Lyme disease. This case also serves as developing insight into the diversity of dTMS.
Methods:
Thirty daily sessions of dTMS were administered over the lPFC using the Brainsway H1 coil at 18Hz., 120% of resting hand MT, 1980 pulses per day. Progress was assessed with the PHQ-9, BDI-II, and GAD-7.
Results:
The patient improved but did not respond in her depression. PHQ-9 decreased by 43.4%, GAD-7 decreased by 25% and BDI-II decreased by 38.2%. Cognitively, the patient remitted (PHQ-9 Q7 improved from a 3 to a 1) and she reported an improvement in mental clarity and focus.
Conclusions:
LPFC high frequency dTMS may be helpful for cognitive impairments and or neuropsychiatric symptoms of Lyme disease. Further investigations are warranted.
