BackgroundIt has been suggested that neuroborreliosis in children can manifest as psychiatric neurodevelopmental disorders or cause long‐term neurodevelopmental sequelae. However, previous studies were limited by size and design.MethodsWe performed a nationwide, population‐based, matched cohort study in Denmark between 1995 and 2021. We included all Danish residents <16 years old with a positive Borrelia burgdorferi sensu lato intrathecal antibody index test (children with neuroborreliosis). To form a comparison cohort, we randomly extracted individuals from the general population matched on date of birth and sex 10:1 to children with neuroborreliosis. We calculated hazard ratios (HRs) with 95% CIs of contact to departments of psychiatry, diagnosis of attention deficit disorder, diagnosis of learning or intellectual developmental disorders, or receipt of psychostimulants for attention deficit disorder among children with neuroborreliosis compared with comparison cohort members. We did a sensitivity analysis in the form of a case‐control study, where we examined whether these outcomes were more frequent among children with neuroborreliosis than in the comparison cohort before study inclusion to account for differential delay in diagnosis.ResultsWe included 1,132 children with neuroborreliosis and 11,320 comparison cohort members with an observation time of 168,858 person‐years. We found no associations between neuroborreliosis and contact with departments of psychiatry (HR: 1.0, 95% CI 0.9–1.2), diagnosis of attention deficit disorder (HR: 0.9, 95% CI 0.6–1.3), diagnosis of learning or intellectual developmental disorders (HR 0.8, 95% CI 0.5–1.4), or receipt of psychostimulants for attention deficit disorder (HR: 0.8, 95% CI 0.6–1.1). Also, in the sensitivity analyses, these outcomes were not more present among children with neuroborreliosis than in the comparison cohort before study inclusion.ConclusionsOur results do not support that neuroborreliosis in children manifests as psychiatric neurodevelopmental disorders or causes long‐term neurodevelopmental sequelae.

中文翻译：

---

儿童神经疏螺旋体病与精神神经发育障碍之间没有关联：一项全国性的、基于人群的匹配队列研究


背景研究表明，儿童神经疏螺旋体病可表现为精神神经发育障碍或导致长期神经发育后遗症。然而，以前的研究受到规模和设计的限制。方法我们于 1995 年至 2021 年间在丹麦进行了一项全国性的、基于人群的匹配队列研究。我们纳入了所有 <16 岁且伯氏疏螺旋体鞘内抗体指数检测呈阳性的丹麦居民 （神经疏螺旋体病儿童）。为了形成一个比较队列，我们从出生日期和性别与 10：1 神经疏螺旋体病儿童相匹配的一般人群中随机提取个体。我们计算了与对照组成员相比，神经疏螺旋体病儿童与精神病学部门接触、注意力缺陷障碍诊断、学习或智力发育障碍诊断或接受精神兴奋剂治疗注意力缺陷障碍的风险比 （HRs） 和 95% CI。我们以病例对照研究的形式进行了敏感性分析，在研究纳入之前，我们检查了神经疏螺旋体病儿童的这些结局是否比对照组更频繁，以解释诊断的差异延迟。结果我们纳入了 1,132 名神经疏螺旋体病患儿和 11,320 名对照队列成员，观察时间为 168,858 人年。我们发现神经疏螺旋体病与与精神病学部门的接触 （HR： 1.0， 95% CI 0.9-1.2）、注意力缺陷障碍的诊断 （HR： 0.9， 95% CI 0.6-1.3）、学习或智力发育障碍的诊断 （HR 0.8， 95% CI 0.5-1.4） 或接受精神兴奋剂治疗注意力缺陷障碍 （HR： 0.8， 95% CI 0.6-1.1） 之间没有关联。 此外，在敏感性分析中，这些结局在神经疏螺旋体病儿童中并不比研究纳入前的对照组更明显。结论我们的结果不支持儿童神经疏螺旋体病表现为精神神经发育障碍或导致长期神经发育后遗症。