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That group also demonstrated a significant decrease in brain-derived neurotrophic factor, which is thought to play a key role in a variety of neuroplastic processes, including pain modulation/transduction, nociception, and hyperalgesia

However, later-stage cases may have symptoms that linger for 6 months or longer after antibiotic treatment has finished, and patients may require nutritional therapy to overcome long-term symptoms of pain, fatigue and brain fog, a condition known as Post-Treatment Lyme Disease Syndrome (PTLDS)

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