– Bonnie Crater, founder and vice-chair of the Board of Directors, Bay Area Lyme Foundation
“I was driving down a road that I’ve driven 1,000 times and suddenly I had no idea where I was or where I was going. So, I pull over to the side of the road to get myself oriented, and then 5-10 minutes later, I remembered and drove to my destination.”
Several friends affected by Lyme have told me of this same experience. It’s caused by the brain fog symptom of Lyme disease, which is often called “mild cognitive impairment” by physicians. I first learned about brain fog when my friend Laure and I founded the Bay Area Lyme Foundation. She explains it like this:
“My nature is to be prompt, attentive and on top of things. It’s important to me to remember people and conversations, and follow up later. Brain fog makes me feel like my brain is muffled with cotton, and it turns me into a “flake” which is very frustrating and hard for me to accept. There are times my brain has been so confused and my spatial awareness is so poor that I’ve actually walked right into a wall. Often, when I am experiencing brain fog, I have to read paragraphs numerous times, and can’t comprehend the content or remember the beginning of the paragraph by the time I’ve gotten to the end.”
As you can imagine, experiencing brain fog—and the cognitive dysfunction involving memory problems, lack of mental clarity, and poor concentration that comes along with it—is very scary for Lyme patients.
So, what is brain fog? It is defined as a temporary state of diminished mental capacity marked by inability to concentrate or to think or reason clearly. For Lyme patients, brain fog seems to manifest by decreasing your ability to think, causing you to feel confused or disorganized and making it difficult to focus or put thoughts into words. So, why do Lyme patients suffer from it? To unpack this a bit, let’s look at some research. Nearly 20 years ago in 2000, Dr. Diego Cadavid and other researchers published a study in Nature where they explored the dissemination of the Lyme bacteria Borrelia burgdorferi (Bb) in non-human primates. They found the bacteria in several organs including the skeletal muscle, heart (aorta), and bladder. They also found the bacteria in the primate brains (pictured below).
For some Lyme patients, the brain fog they experience can, in severe cases, resemble some phases of Alzheimer’s disease. In a curious related finding, Dr. Alan MacDonald discovered Bb in a large percentage of Alzheimer’s brains—7 of 10 Alzheimer’s brains had signs of a Bb infection in his 2007 pilot study. If Bb and brain fog are connected, that raises an interesting question: How might infection with Bb in the brain be causing brain fog?
In 2012 I met Jay Rajadas at Stanford University. His father-in-law sadly had Alzheimer’s disease, and Dr. Rajadas became very interested in studying amyloid plaques found in the brain of Alzheimer’s patients. He also wanted to investigate a possible connection to Borrelia infection. To gain more insight, Dr. Rajadas initiated a study and Bay Area Lyme Foundation and the L.K. Whittier Foundation funded this initial research. By 2015, Dr. Rajadas had started collaborating with additional researchers. Together, they conducted laboratory and mouse studies to understand the impact Bb may have on neurons in the brain. They hypothesized that the lipopeptides, fatty compounds that are sloughed off by the Bb bacteria, may interfere in the communication between neurons. They conducted PET scans on mice and tested the effect of the presence of a synthetic lipopeptide on the communication of neurons. What they found is that, in the presence of the lipopeptide, the density of the communication sites between neurons were significantly lower and there was a disruption in the synaptic signaling. This result suggests that some neural pathways might get disrupted. Could this disrupted signaling be causing the brain fog?.
What does this mean for Lyme patients? This week, results of years of hard work were published in the Journal of Neuroscience that provide clues that answer this question. For the first time, researchers have demonstrated that lipopeptides associated with Bb cause dysfunction in the brain of mice. It also gives us more to consider.
If this research is confirmed by others, we now have a new hypothesis to test: Do lipopeptides disrupt neural pathways? And, if we can keep Lyme patients free of lipopeptides in the brain, will they stop having brain fog symptoms? While the lipopeptide effect is exciting new information, more research is needed to confirm these findings and find solutions for Lyme patients. The work today offers another clue about how Lyme disease causes neurological symptoms and another piece of information we can use to solve the Lyme disease problem.
Our hope is that one day Lyme disease will be easy to diagnose and simple to cure.