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Biology and Neuropathology of Dementia in Syphilis and Lyme Disease

2008; Elsevier BV; Linguagem: Inglês

10.1016/s0072-9752(07)01272-9

2212-4152

Judith Miklossy,

Body Image and Dysmorphia Studies

This chapter emphasizes that treponema pallidum, subspecies pallidum can occur in late stages of neurosyphilis cause dementia, cortical atrophy, and amyloid deposition. The occurrence of dementia, including subacute presenile dementia, was reported in association with Lyme disease caused by another spirochete, Borrelia burgdorferi. Both spirochetes are neurotropic and in both diseases the neurological and pathological manifestations occur in three stages. They both can persist in the infected host tissue and play a role in chronic neuropsychiatric disorders, including dementia. The chapter describes that B. burgdorferi, similarly to T. pallidum, is present at the site of inflammation in many organs, including the brain. Both spirochetes may invade a wide range of tissues. They frequently and preferentially invade conjunctive tissue and extracellular matrix at the first stages of infection but both invade parenchymal cells as well. The involvement of the central nervous system (CNS) may occur years or decades following the primary infection. It is in the tertiary stage of neurosyphilis or late neurosyphilis that dementia develops. General paresis is the most common cause of dementia in neurosyphilis; however, meningovascular syphilis may also contribute to "vascular" dementia by the generation of multiple cerebral infarcts. In mixed forms both participate.