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Special Articles   |    
Post-Treatment Lyme Syndrome and Central Sensitization
Shweta Batheja, M.B, B.S.; Jenifer A. Nields, M.D.; Alla Landa, Ph.D.; Brian A. Fallon, M.D., M.P.H.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:176-186. doi:10.1176/appi.neuropsych. 12090223
View Author and Article Information

This work was supported in part by the Lyme & Tick-borne Diseases Research Center at Columbia University Medical Center, established by the Lyme Research Alliance, Inc. and the Lyme Disease Association, Inc.

From the Department of Psychiatry, Columbia University, and The New York State Psychiatric Institute.

Send correspondence to Dr. Fallon; e-mail: baf1@columbia.edu

Copyright © 2013 American Psychiatric Association

Received September 17, 2012; Accepted October 23, 2012.

Abstract

Central sensitization is a process that links a variety of chronic pain disorders that are characterized by hypersensitivity to noxious stimuli and pain in response to non-noxious stimuli. Among these disorders, treatments that act centrally may have greater efficacy than treatments acting peripherally. Because many individuals with post-treatment Lyme syndrome (PTLS) have a similar symptom cluster, central sensitization may be a process mediating or exacerbating their sensory processing. This article reviews central sensitization, reports new data on sensory hyperarousal in PTLS, explores the potential role of central sensitization in symptom chronicity, and suggests new directions for neurophysiologic and treatment research.

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TABLE 1.Symptom Frequency Among 120 Patients With Post-Treatment Lyme Syndrome
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TABLE 2.Factors That Trigger or Predispose to Central Sensitization
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