Objective: The goal of this study was to more precisely define the nature o
f the cognitive processing deficits in the patients with Lyme disease. Back
ground: Lyme disease has been associated with cognitive disturbances. Metho
d: Sixteen patients who met the Centers for Disease Control's case definiti
on for Lyme disease and 15 age- and education-matched control subjects comp
leted two computerized assessments. The first was a matching procedure that
assessed perceptual/motor speed. The second task was an alphabet-arithmeti
c (AA) test that measured the speed of mental arithmetic. On the matching t
ask, subjects judged as true or false simple identity equations (e.g., B O = B). On the AA task, subjects indicated the veracity of equations of the
same form as those of the matching task but which required mental arithmet
ic (e.g., A + 3 = D). The use of this paradigm permits sensory or motor slo
wing to be distinguished from slowed cognitive processing speed. Also, the
tests do not involve automated or overlearned responses. Results: Lyme dise
ase patients and healthy controls did not differ in perceptual/motor speed.
However, Lyme disease patients' response times were significantly longer t
han those of healthy controls during the AA task, demonstrating specific im
pairments in mental activation speed. Conclusions: These results suggest th
at Lyme disease patients show specific deficits when initiating a cognitive
process. These impairments are independent of sensory, perceptual, or moto
r deficits.