Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[What are important goals in the treatment of people with primary progressive aphasia?]","authors":"Nina Unger, Christina J Molt, Lea K Heidelmann, Anna U Rysop, Anna Volkmer, Agnes Flöel, Marcus Meinzer","doi":"10.1055/a-2723-6584","DOIUrl":"10.1055/a-2723-6584","url":null,"abstract":"<p><strong>Background: </strong>Primary progressive aphasia (PPA) is a neurodegenerative disease that leads to progressive impairment of language and communication, with serious consequences for the daily lives of affected patients.</p><p><strong>Objective: </strong>As part of an international research collaboration (https://www.comet-initiative.org/Studies/Details/1871), important endpoints for investigating the success of (speech and language) therapy for people with PPA were developed (Core Outcome Set for PPA, COS-PPA). Here we report the results from Germany, discuss them in the context of the overall project, and compare them with the core outcomes for post-stroke aphasia.</p><p><strong>Methods: </strong>Six small group interviews were conducted with n=9 patients with PPA and n=13 caregivers using the nominal group technique to ask about wishes and goals regarding communication and speech-language therapy as well as their importance.</p><p><strong>Results: </strong>PPA patients emphasised linguistic goals, while care partners focused on communication relevant to everyday life and psychological aspects. The international COS-PPA results were largely consistent with the findings in Germany and also showed a focus on language and communication. A comparison of the German survey results with the COS for aphasia after stroke revealed particular overlap regarding the improvement of language, communication, and quality of life.</p><p><strong>Conclusions: </strong>Taking into consideration the wishes and treatment goals in PPA can contribute to the planning of therapy and to the standardization of research methods in clinical trials. However, the individual character of the treatment should be preserved.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"266-273"},"PeriodicalIF":0.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A novel mutation causing adult Alexander disease presenting as cervical spine tumor].","authors":"Nadja Saric, Maximilian Rink, Beate Schoch, Hans-Hermann Görge, Werner Paulus","doi":"10.1055/a-2777-1997","DOIUrl":"10.1055/a-2777-1997","url":null,"abstract":"<p><strong>Abstract: </strong>The present report describes a patient with Alexander's disease occurring in late adulthood. The genetic mutation reported in this case has not been known or reported before. The 47-year-old patient presented in our clinic with various neurological symptoms. A microsurgical partial resection was performed and showed the diagnosis stated above. Postoperatively, the symptoms continued to persist. The patient underwent interdisciplinary rehabilitation.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"314-316"},"PeriodicalIF":0.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Para-infectious aseptic meningo-encephalitis following SARS-CoV-2 infection: two case reports].","authors":"Dania Humaidan, Vivien Richter, Ulf Ziemann, Markus Kowarik","doi":"10.1055/a-2853-8086","DOIUrl":"10.1055/a-2853-8086","url":null,"abstract":"<p><strong>Abstract: </strong>Neurological manifestations following COVID-19 have been increasingly reported, yet the pathophysiology of para-infectious processes remains unclear.We present two patients who developed headaches, gait instability, cognitive impairments, and inflammatory cerebrospinal fluid (CSF) changes after SARS-CoV-2 infection. Imaging revealed meningitis and encephalitis, respectively, but there was no direct pathogen detection. After excluding other causes and initiating corticosteroid therapy, both patients showed significant improvement. These cases highlight the relevance of autoimmune mechanisms in neurological complications after COVID-19. Both patients developed their neurological symptoms within four weeks after SARS-CoV-2 infection and thus formally still during the acute phase of COVID-19. In patients with neurological symptoms and inflammatory CSF findings following SARS-CoV-2 infection, para-infectious meningo-encephalitis should be considered, and corticosteroid therapy may be warranted.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"309-313"},"PeriodicalIF":0.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Providing Cognitive Remediation Therapy to People with Schizophrenia: Results of a Survey in Psychiatric Clinics in Germany].","authors":"Tim Schuster, Mathias Riesbeck, Daniel Kamp, Wolfgang Gaebel, Peter Falkai, Alkomiet Hasan, Wolfgang Wölwer","doi":"10.1055/a-2294-8371","DOIUrl":"10.1055/a-2294-8371","url":null,"abstract":"<p><strong>Abstract: </strong>Schizophrenia is accompanied by significant cognitive impairments, which often persist to a relevant extent after remission of clinical symptoms and has a negative impact on psychosocial functioning. These impairments are often experienced as very stressful by those affected. Under the umbrella term of Cognitive Remediation Therapy (CRT), evidence-based therapy options are available that improve both the respective cognitive target functions and the psychosocial functioning. According to expert recommendations, at least 20 sessions should be carried out, accompanied by qualified therapeutic staff. The current edition of the S3 treatment guideline schizophrenia of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology recommends CRT with the highest level of recommendation. It is unclear to what extent CRT has become part of routine inpatient care. Between July 2021 and May 2022, 395 psychiatric university hospitals and non-university psychiatric specialist hospitals in Germany were invited to fill in a 14-item questionnaire. A total of 103 institutions took part in the survey; 56.3% of these hospitals used at least one evidence-based CRT programme. Among the CRT programmes used, Cogpack, Rehacom and the Integriertes Psychologisches Therapieprogramm (IPT) were named most frequently. In 87.5% of the participating facilities, fewer than half of the people with schizophrenia received CRT. With regard to the clinics which used evidence-based CRT, 64.3% carried out fewer than 11 therapy sessions, 28.6% between 11 and 20 sessions and 7.2% more than 20 sessions. It is thus clear that CRT is not yet offered in all of the participating psychiatric hospitals in Germany, not yet for all people with schizophrenia, and not yet with sufficient intensity, with clinics indicating the need for more technical and personnel resources and more extensive development of competencies for CRT application.The low response rate of 26.1% and possible selection effects for participation in the study are addressed and are to be seen as limitations.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"290-298"},"PeriodicalIF":0.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Transiente globale Amnesie (TGA).","authors":"Dirk Sander","doi":"10.1055/a-2876-7164","DOIUrl":"https://doi.org/10.1055/a-2876-7164","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"94 7-08","pages":"317-326"},"PeriodicalIF":0.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Disastrous conditions: Forensic Psychiatry in Eastern Germany - The 'Haus 213' in Berlin-Buch].","authors":"Rainer Erices","doi":"10.1055/a-2643-5711","DOIUrl":"10.1055/a-2643-5711","url":null,"abstract":"<p><strong>Aim and methodology: </strong>This article analyzes the little-examined forensic psychiatry in the GDR after the enactment of the Criminal Code of 1968. Using files from the Berlin State Archive, the Federal Archive and the Stasi Records Archive, it traces the historical development of the forensic psychiatric clinic in Berlin-Buch, \"Haus 213\".</p><p><strong>Results: </strong>Like other closed psychiatric clinics, House 213 suffered from overcrowding, inadequate security measures and increasingly catastrophic structural conditions until the end of the GDR. After the 1968 reform and the abolition of the GDR's \"Maßregelvollzug\", it took years before the prescribed diagnostic criteria for the admission of patients were fundamentally implemented. Leading doctors at the clinic constantly criticized the therapeutic possibilities. The Police (Deutsche Volkspolizei) and State Security ('Stasi') criticized the high number of patient escapes. Extensive plans to renovate the clinic were not implemented. There were no consistent concepts and the patients lived in disastrous conditions. Those responsible were aware that both the state and the SED were failing to provide psychiatric care for offenders. The Stasi used the Berlin-Buch clinic for forensic psychiatric assessments and maintained close working relationships with House 213. Senior doctors worked as Stasi informers.</p><p><strong>Conclusion: </strong>It is clear that the political, economic and institutional framework conditions had a considerable influence on the possibilities of forensic psychiatry in the GDR. The deficiencies in structural equipment and staffing, as well as the interference of the State Security, raise fundamental questions about the role and responsibility of the state in the care of mentally ill offenders. Future research should focus more on the analysis of forensic psychiatric clinics and their specific treatment concepts or options. This would also appear useful in order to provide differentiated answers to questions about the possible misuse of psychiatry or forensic psychiatric assessment in the context of political criminal proceedings.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"299-308"},"PeriodicalIF":0.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of the PEPP reimbursement system and other developments on inpatient care of general psychiatry patients 2005 to 2022: a retrospective analysis].","authors":"Evgeny Chula, Olaf Bick, Adieb Hazzan, Aleksandr Rakitin, Eugen Davids, Nils Diogo Nellessen","doi":"10.1055/a-2866-8766","DOIUrl":"https://doi.org/10.1055/a-2866-8766","url":null,"abstract":"<p><strong>Introduction: </strong>The traditional division of clinical psychiatry in Germany comprises general psychiatry, geriatric psychiatry and addiction medicine. It is important to know how factors such as age, gender, length of stay, comorbidities and concomitant medication have developed in these areas in order to understand future care needs. The billing system (abbreviated as \"PEPP\") unique to Germany was introduced in 2018 and brought structural changes to psychiatric care. This study focuses on a retrospective, longitudinal observation in general psychiatry, describes developments, and examines the impact of the PEPP reimbursement system on length of stay and coding of diagnoses in general psychiatry.</p><p><strong>Methods: </strong>The Evangelische Stiftung Tannenhof operates a specialist hospital for psychiatry, psychotherapy, psychosomatics and neurology with a compulsory care area containing 580,000 inhabitants. Data from the hospital information system was analysed in a descriptive manner. A total of 61,385 inpatient cases from general psychiatry belonging to the ICD-10 diagnosis groups F2, F3, F4 and F6 were included. Demographic data, length of stay and the development of psychiatric main and somatic secondary diagnoses as well as medication prescriptions were analysed.</p><p><strong>Results/discussion: </strong>The gender distribution and age structure in general psychiatry remained largely constant between 2005 and 2022. The number of cases increased continuously and the length of stay decreased continuously. The main diagnoses from the general psychiatry group remained relatively stable with the affective disorders group being the largest. The total number of psychiatric and somatic medications prescribed increased progressively, especially the share with somatic indications. During the COVID-19 pandemic, Z diagnoses were frequently assigned as secondary diagnoses.</p><p><strong>Conclusions: </strong>The retrospective analysis of patient data in general psychiatry between 2005 and 2022 shows that the age structure and main diagnoses have remained relatively stable. In contrast, the increase in the prescription of medication and somatic secondary diagnoses is an important development that emphasises the need for increased training and interdisciplinary collaboration in the care of psychiatric patients.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Digital transformation in multiple sclerosis: Advances in diagnostics, monitoring and patient-centred care].","authors":"Isabel Voigt, Hernan Inojosa, Marc Pawlitzki, Lars Masanneck, Sven Günther Meuth, Tjalf Ziemssen","doi":"10.1055/a-2890-0999","DOIUrl":"https://doi.org/10.1055/a-2890-0999","url":null,"abstract":"<p><strong>Abstract: </strong>Digital transformation is fundamentally changing the diagnosis, monitoring and treatment of multiple sclerosis. The integration of multimodal data from imaging, laboratory tests, clinical assessments, patient-reported outcomes and continuous measurements via wearables is creating high-resolution, longitudinal profiles of disease progression. Based on this data, modern analysis methods and artificial intelligence enable predictive models for disease activity, progression and therapeutic response, supporting personalised decision-making. Digital patient pathways and patient portals open up new options for participatory, standardised care, while telemedicine, telerehabilitation and digital health applications complement care regardless of location and time. In research, real-world data, federated learning and virtual, decentralised studies are accelerating patient-centred evidence generation. Concepts such as the digital twin outline the next stage of development in simulation-based precision medicine. Key challenges relate to data protection and data security, data quality, interoperability, bias, transparency and the traceability of algorithmic decisions. Overall, digitalisation offers substantial opportunities to detect disease activity earlier, optimise treatment goals and improve quality of life and care - provided that technical, regulatory and ethical requirements are consistently addressed and translated into scalable care models.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The pathology of the brain eating amoeba Naegleria fowleri].","authors":"Yannick Borkens","doi":"10.1055/a-2890-0961","DOIUrl":"https://doi.org/10.1055/a-2890-0961","url":null,"abstract":"<p><strong>Abstract: </strong>The genus <i>Naegleria</i> is a taxonomic subfamily consisting of 47 free-living amoebae. The genus can be found in warm aqueous or soil habitats worldwide. The species <i>Naegleria fowleri</i> is probably the best-known species of this genus. As a facultative parasite, the protist is not dependent on hosts to complete its life cycle. However, it can infect humans by entering the nose during water contact, such as swimming, and travel along the olfactory nerve to the brain. There it causes a purulent meningitis (primary amoebic meningoencephalitis or PAME). Symptoms are severe and death usually occurs within the first week. PAME is a frightening infectious disease for which there is neither a proven cure nor a vaccine. In order to contain the disease and give patients any chance to survival, action must be taken quickly. A rapid diagnosis is therefore crucial. PAME is diagnosed by the detection of amoebae in the liquor and later in the cerebrospinal fluid. For this purpose, CSF samples are cultured and stained and finally examined microscopically. Molecular techniques such as PCR or ELISA support the microscopic analysis and secure the diagnosis.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recent developments in the early detection and treatment of clinical high-risk stages of psychosis].","authors":"Anastasia Theodoridou, Tri Kurniati Ambarini, Frauke Schultze-Lutter","doi":"10.1055/a-2883-4988","DOIUrl":"https://doi.org/10.1055/a-2883-4988","url":null,"abstract":"<p><strong>Abstract: </strong>Three decades of research into early detection of and intervention in psychosis have produced specific risk criteria that indicate an average 300-fold increase in risk in the first step and allow for initial risk stratification using a combination of \"ultra-high risk\" and basic symptom criteria. A variety of models have already been proposed for further, personalized risk evaluation, but few of these have been externally validated. With regard to psychosis prevention interventions, cognitive-behavioral approaches have proven superior, although recent studies have shown them to be of limited effectiveness, which is why modular, stepwise procedures and alternative substances are currently being researched. Against the backdrop of clinical psychosis risk as an independent syndrome, the focus is shifting from psychosis manifestation to other outcomes, such as functioning or remission.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}