At first glance, autism spectrum disorder and Lyme disease may not appear to be similar, but in young children, several characteristic symptoms overlap. Is there a link?
Autism spectrum disorder (ASD) is a collective term for neurological disorders in which some aspect of communication, the ability to form relationships with others, and the response to environmental stimuli are impaired. Although the specific causes of ASD are unknown, it appears that numerous factors may play a role, such as inherited genetic patterns, exposure to chemicals and heavy metals, and certain biological agents. It has been found that infections may play an important role in the development of ASD, as various pathogens—namely viruses, bacteria and fungi—have been detected in samples taken from numerous patients diagnosed with ASD. The Taenia solium parasite, for example, is one of the causes of neurocysticercosis, common symptoms of which include epilepsy, headaches, dizziness, cerebrovascular accidents and neuropsychiatric disorders. This condition develops when cysts form in the brain as a result of the spread of the infection. Toxoplasmosis is caused by Toxoplasma gondii, a protozoan. It generally does not cause any significant symptoms in adults. It is typically contracted through the consumption of undercooked food containing cysts, contact with infected cat faeces, and transplacentally, i.e. from mother to child during pregnancy if the mother is infected. (1)
At first glance, autism spectrum disorder and Lyme disease may not appear similar, but in young children, several characteristic symptoms overlap. Among neurological symptoms, these include disorientation, brain fog, confusion, sensitivity to light, muscle twitching, communication difficulties, and physical and mental developmental disorders. Among the psychological symptoms, there are also those that can be observed in both conditions, though recognising them is far more complex: anxiety, mood swings and behavioural disorders. Physical symptoms, such as joint inflammation, rashes and muscle weakness, are also observed in both Lyme disease and autism spectrum disorder, but symptoms affecting the digestive system do not provide a clear answer as to which diagnosis is correct: food allergies, bloating, constipation or diarrhoea, and general lower abdominal pain. Of course, other conditions may also present with similar symptoms; for instance, most gastrointestinal symptoms are also characteristic of autoimmune diseases, and in adulthood, Lyme disease is often misdiagnosed as arthritis or fibromyalgia.
Lyme disease is the most common vector-borne disease, typically spread through tick bites – specifically, in Europe, by the Ixodes species. The incidence of Lyme borreliosis is steadily rising, and there may be several factors behind this. One of these is the possibility of transmission from mother to foetus. The first scientific evidence was documented in 1985, when a mother and her newborn were found to have a vertically transmitted Lyme infection. There is scientifically substantiated evidence that Borrelia, the spirochete bacterium that causes Lyme disease, is capable of crossing the placenta from mother to foetus. The acronym TORCH, familiar from numerous books on congenital infectious diseases and describing the most fundamental congenital infectious diseases, has been expanded to TORCHES-CLAP, where the letter L stands for Lyme disease. (T: Toxoplasma, R: Rubella, C: Cytomegalovirus, H: Herpes simplex, E: Enterovirus, S: Syphilis, C: Chickenpox, L: Lyme, A: AIDS, P: Parvovirus B19.) (8)
One unknown but plausible explanation for the development of autism spectrum disorder is vertical transmission, i.e. foetal infection during pregnancy. Bransfield and colleagues proposed this theory and identified 24 infections and co-infections that may contribute to the development of autism spectrum disorder in early childhood. If this is the case, it raises several unanswered questions: does the primary form of infection occur in infancy or during pregnancy? Is the underlying cause of the condition a direct infection of the nervous tissue, a secondary immune response to an infection, or perhaps both?
An American study has drawn attention to the link between Lyme disease and other tick-borne illnesses and certain childhood neuropsychiatric disorders. Of the states with the highest incidence of autism, 15 reported more cases of Lyme disease than average. Conversely, of the states with the lowest incidence of autism, not a single state reported more cases of Lyme disease than average. This suggests a correlation between the incidence of the two conditions. (2)
Although clinicians had previously raised the possibility of a link between Lyme disease and autism spectrum disorder, this was the first study in this field to provide a comprehensive overview of the medical histories of 102 cases of Lyme disease contracted during pregnancy. Nine per cent of the subjects were diagnosed with autism, and most were also found to have some form of developmental disorder. A control group of 66 mothers with Lyme disease who had received antibiotics both before conception and during pregnancy was examined: all of them gave birth to healthy newborns. In 25% of children with autism spectrum disorder, the causative agent of Lyme disease, Borrelia burgdorferi, can be detected. (3)
Diseases transmitted by ticks, such as infection with Borrelia burgdorferi (the causative agent of Lyme disease), may facilitate the development of other infections and induce a weakened, sensitive, and immunologically vulnerable state during foetal and infant development, which is conducive to the development of autism spectrum disorder. These disorders also feed into one another and, in the presence of other factors, can trigger immune responses that, in susceptible individuals, lead to inflammation, molecular mimicry, changes in the kynurenine metabolic pathway, elevated quinolinic acid levels, reduced serotonin levels, oxidative stress, mitochondrial dysfunction and excitotoxicity in susceptible individuals. All of these inhibit the development of the amygdala and other neural structures and networks, which may lead to the development of partial Klüver–Bucy syndrome, autism spectrum disorder and other neuropsychiatric conditions.
This hypothesis is supported by numerous cases of pregnant women with Lyme disease and children diagnosed with autism spectrum disorder, as well as foetal neurological abnormalities associated with tick-borne diseases. Furthermore, the similarities between tick-borne diseases and the symptoms, pathophysiology, immune response, temporal lobe pathology and results of brain imaging procedures in autism spectrum disorder should not be overlooked. (7)
In their research into congenital Lyme disease, Charles Ray Jones and colleagues found that treating Lyme disease and other tick-borne diseases during pregnancy can prevent the development of autism and other developmental disorders caused by these conditions. (4)
A study by Mason Kuhn and colleagues examining the effects of long-term antibiotic therapy objectively demonstrated that antibiotic treatment reduces symptoms of autism spectrum disorder associated with Lyme disease/tick-borne diseases. (5)
We also present data presented at a conference but not yet published in an official journal: a paediatrician specialising in autism, who is also a Lyme disease expert, shared his clinical experiences. He administered combined antibiotic treatment to more than 100 children diagnosed with autism and Lyme disease. In nearly 60 per cent of cases, the symptoms of autism (some of which are shared with Lyme disease) improved, whilst in 8 per cent the symptoms became more severe – the latter was resolved by the concurrent administration of an antifungal agent.
Another ‘mysterious’ childhood condition linked to foetal Lyme disease is SMA, or spinal muscular atrophy. Recent studies also suggest a link between ALS (amyotrophic lateral sclerosis) and SMA (spinal muscular atrophy). (6)
A previous summary article published on Weborvos provided a detailed account of the possible transmission of Lyme disease from mother to foetus, which, it appears, may be closely linked to the explanation of the connection between Lyme disease and autism spectrum disorder (8).
Further interesting video material:
A young boy diagnosed with autism who tested positive for Lyme disease, babesiosis and mycoplasmosis: https://www.youtube.com/watch?v=k4X2LdQmHrY
An interview from 2008 with Dr Luc Montagnier, winner of the Nobel Prize in Medicine for the discovery of the HIV virus, in French with English subtitles, on his research topic at the time: the link between autism and Lyme disease: https://www.youtube.com/watch?v=LRQ-NhEkLXU
References
(1) M Zubair Alam, Q Alam, M Amjad Kamal, A Ahmad Jiman-Fatani, EI Azhar, M Azhar Khan…Infectious agents and neurodegenerative diseases: exploring the links Current topics in medicinal chemistry, 2017 [PubMed]
(2) Kuhn M, Grave S, Bransfield R, Harris S. Long-term antibiotic therapy may be an effective treatment for children co-morbid with Lyme disease and Autism Spectrum Disorder. Med Hypotheses. (2012) 78:606–15. 10.1016/j.mehy.2012.01.037 [PubMed] [CrossRef] [Google Scholar]
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(6) Cetin B. A new complication of Lyme disease; spinal muscular atrophy. Eur J Biomed Pharm Sci. (2019) 6:464–8. Available online at: https://madisonarealymesupportgroup.files.wordpress.com/2019/09/article_ejbps_volume_6_august_issue_8_1564794140.pdf [Google Scholar]
(7) RC Bransfield, JS Wulfman, WT Harvey, AI Usman The association between tick-borne infections, Lyme borreliosis and autism spectrum disorders- Medical hypotheses, 2008 – Elsevier [PubMed]
(8) The Foundation’s summary article based on multiple sources: Transmission of Lyme disease from mother to foetus
(C) Lyme Borreliosis Foundation
