To the Editor In their Viewpoint published in JAMA Neurology, Melia et al1 discussed diagnosis of Lyme disease, a tick-borne infection caused by the spirochete Borrelia burgdorferi, focusing primarily on the disease’s affliction of the central nervous system, which is a condition commonly referred to as neuroborreliosis.
When it comes to laboratory testing for neuroborreliosis, the authors particularly emphasized the usefulness and pitfalls of serologic testing including IgG and IgM immunoblots as well as assessment of the B burgdorferi antibody ratio between cerebrospinal fluid (CSF) and blood. We fully agree that serologic testing represents one of the key elements in the diagnostic workup of patients with suspected neuroborreliosis. However, we believe that in a clinical setting, additional basic CSF analyses should be taken into account along with the clinical assessment.
Lautner R, Zetterberg H, Blennow K. Laboratory Testing for Lyme Neuroborreliosis. JAMA Neurol. 2015;72(1):125-126. doi:10.1001/jamaneurol.2014.3552