Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[News on blood biomarker-based early diagnosis of the preliminary stages of Alzheimer's dementia].","authors":"Niels Hansen, Jens Wiltfang","doi":"10.1055/a-2698-5992","DOIUrl":"https://doi.org/10.1055/a-2698-5992","url":null,"abstract":"<p><p>The early diagnosis of Alzheimer's disease (ADD) has gained new significance through the further discovery of blood biomarkers. Blood biomarkers are less expensive, can be measured fully automatically with high throughput, are less invasive and provide faster information on specific dementia biomarkers than current methods used in routine clinical practice such as amyloid positron emission tomography (PET) or CSF examination of underlying pathological changes in Alzheimer's disease (AD) in patients with cognitive impairment. The aim of this review is to provide a presentation of the added value of blood-based biomarkers for the early diagnosis of ADD. Individual blood biomarkers are presented regarding their diagnostic reliability and predictive value for the diagnosis of AD in precursors of ADD ranging from subjective cognitive impairment (SCD) to mild cognitive impairment (MCI). In addition, the revised criteria for the diagnosis and staging of AD are discussed. Markers of tau pathology such as a phosphorylated tau protein 217 (p-tau217), a phosphorylated tau protein 181 (p-tau181), a phosphorylated tau protein 231 (p-tau231), but also amyloid-β (Aβ) markers such as the ratio of Aβ1-42/ 1-40 are described as specific biomarkers for the early diagnosis of AD. In addition, new amyloid peptide ratios such as Aβ-3-42/-3-40 are discussed, which may provide more insights into the pathogenesis of AD, as this N-terminal elongated Aβ peptides are cleaved from the amyloid precursor protein via a biochemical oligodendroglia-dependent pathway (ADAMTS4=disintegrin and metalloproteinase with thrombospondin motifs 4), which is important in AD pathophysiology due to oligodendroglia involvement. In addition, new promising composite hybrid ratios are explained, which could provide advantages in the early diagnosis of AD, such as the AT217-term or the AT181-term, which relates Aβ1-40 to Aβ1-42 and multiplies it by p-tau217 and p-tau181, respectively. Overall, the review provides an overview of the potential of blood biomarkers in the early diagnosis of ADD. However, these biomarkers should not be used alone for early diagnosis, but should always be evaluated in conjunction with other tests such as cerebrospinal fluid analysis.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"93 11","pages":"446-452"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458123","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":"[Disease-modifying therapy with lecanemab for early Alzheimer's dementia].","authors":"Niels Hansen, Jens Wiltfang","doi":"10.1055/a-2681-4558","DOIUrl":"10.1055/a-2681-4558","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is a severe and progressive neurodegenerative disease of the brain that has so far been treated with symptomatic drug and non-drug therapies as standard treatment. Following the approval of the monoclonal anti-amyloid antibody by the FDA, AD therapy has changed, as this therapy has made it possible to attenuate the biological disease process of AD. Lecanemab has been recommended by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) for approval in patients with early AD under two conditions. Firstly, homozygous ApoE4 carriers and secondly, patients receiving oral anticoagulants should not receive lecanemab. The following narrative review explains the mechanism of action, safety and side effects of lecanemab. Furthermore, risk factors for side effects are described. Finally, the first experiences with lecanemab are reported and the efficacy and financial aspects are discussed. Lecanemab leads to a temporary reduction in amyloid-ß deposits and to a benefit that can be reflected in everyday competence, cognition and quality of life and can be described as a breakthrough in AD's therapy due to its demonstrable biological and clinical efficacy.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"453-460"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Wilson's disease - interdisciplinary networking, better treatment].","authors":"Ulrike Reuner, Jürgen Dinger","doi":"10.1055/a-2588-9131","DOIUrl":"10.1055/a-2588-9131","url":null,"abstract":"<p><p>Morbus Wilson is a rare disease - if detected and treated early, the prognosis is favorable. Symptom freedom and a normal life expectancy are realistic treatment goals. If treatment starts too late, there are often functional impairments, also relevant in everyday life. If left untreated, the disease is fatal. Known as a \"chameleon disease,\" Morbus Wilson is an important differential diagnosis in many medical specialties.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"93 11","pages":"474-494"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458169","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":"[Correction: Home infusion therapy for Pompe disease: Recommendations for German-speaking countries].","authors":"Andreas Hahn, Christina Lampe, Matthias Boentert, Thomas Hundsberger, Wolfgang Löscher, Stephan Wenninger, Andreas Ziegler, Florian Lagler, Diana Ballhausen, Thomas Schlegel, Benedikt Schoser","doi":"10.1055/a-1482-6041","DOIUrl":"10.1055/a-1482-6041","url":null,"abstract":"<p><strong>Background: </strong>Pompe disease is a lysosomal multisystem disorder with predominant proximal myopathy. Treatment with enzyme replacement therapy (ERT) is available requiring life-long biweekly infusions of recombinant α-glucosidase. To minimize the burden of ERT patients ask for home infusion therapy.</p><p><strong>Aims and methods: </strong>Pompe disease experts from Germany, Austria, and Switzerland discussed in two consensus meetings in 2019 and 2020 requirements for home infusion therapy, adequate execution of treatment, and the legal situation for delegating physicians.</p><p><strong>Results and discussion: </strong>Home infusion therapy is principally feasible for patients with Pompe disease if certain preconditions are fulfilled, but the decision to implement has to be made on an individual basis. The treating physician delegates the execution of ERT <i>ad personam</i> to nursing staff but retains full legal responsibility. Home infusion therapy has to be carried out by specially trained and qualified staff. Infusion-related risks comprise mainly allergic reactions, and adequate medical treatment must be warranted. In German-speaking countries, clear rules for conducting home infusion therapy are needed to reduce psychosocial stress for patients with Pompe disease, and providing legal certainty for delegating physicians.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"e2"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38913989","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":"[Correction: Wilson's disease - interdisciplinary networking, better treatment].","authors":"Ulrike Reuner, Jürgen Dinger","doi":"10.1055/a-2759-8299","DOIUrl":"https://doi.org/10.1055/a-2759-8299","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"93 11","pages":"e3"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707911","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":"[Pedophilic Disorder and the Use of Child Sexual Abuse Material: The Need for a Multimodal Treatment Approach].","authors":"Dorit Grundmann, Till Amelung, Klaus M Beier, Laura F Kuhle","doi":"10.1055/a-2681-5204","DOIUrl":"https://doi.org/10.1055/a-2681-5204","url":null,"abstract":"<p><p>In DSM-5 and ICD-11, pedophilic and/or hebephilic disorder is defined by either psychological distress and/or acting on one's sexual preference-such as through the use of child sexual abuse material (CSAM). It is assumed that most CSAM users remain unknown to law enforcement. Studies on undetected CSAM offenders indicate a higher relapse rate compared to forensic samples. This presents unique challenges for treatment, as the goal is not only to alleviate psychological distress but also to achieve complete behavioral control. This study outlines the multimodal treatment approach for CSAM users within the prevention network \"Kein Täter werden\" and examines both psychotherapeutic and pharmacological interventions. Between 2018 and 2023, 570 individuals presented to the Berlin site of the prevention network seeking help. The sample was analyzed based on sociodemographic and diagnostic characteristics, as well as the use of medication to reduce sexual preoccupation. Initial exploratory analyses also assesed relapse rates during therapy. Case studies illustrate the therapeutic approach, and a proposal for treatment guidelines regarding the indication for pharmacological interventions in undetected individuals with pedophilic and/or hebephilic disorder is discussed.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291612","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":"[Pharmacological management of attention-deficit/hyperactivity disorders (ADHD) by generalists and specialists in Germany: a secondary data analysis].","authors":"Thomas Grimmsmann, Wolfgang Himmel","doi":"10.1055/a-2317-0470","DOIUrl":"10.1055/a-2317-0470","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental health disorders among children, and it is rapidly surging among adults as well. The aim of this study was to investigate the role of community neurologists and psychiatrists as well as general practitioners and paediatricians in prescribing ADHD medications in Germany and whether their role has changed over the 10-year period from 2008 and 2018.</p><p><strong>Methods: </strong>In this secondary analysis of anonymized prescribing data, we calculated the absolute and relative frequencies of ADHD prescriptions by neurologists and psychiatrists, summarized as specialists, and family physicians and paediatricians, summarized as generalists, and how it has changed during the years 2008 to 2018.</p><p><strong>Results: </strong>A total of 620 practices delivered data on 77,504 patients diagnosed with ADHD, 38% (29,396/77,504) of them had received a prescription for ADHD medicine at least once in the study period. Over time, we observed a shift from generalists to specialists. While 59% of patients received their prescription from a generalist and 41% from a specialist in 2008, there was reverse in the ratio in 2018: only 37% received their medication from a generalist and the vast majority (63%) from a specialist. This trend was particularly evident among adults: 58% of them received their ADHD medication from a specialist in 2008, but 80% in 2018. The proportion of children and adolescents who received their prescriptions from a specialist rose from 38% to 51% over the same period.</p><p><strong>Conclusion: </strong>There is a shift in drug prescription away from generalists to specialists, without any discussion of advantages or disadvantages so far. However, this would be desirable, not least because specialists alone may not have sufficient resources to care for all ADHD patients.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"395-402"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intrajejunal levodopa in Parkinson's disease: Optimization of PEG application].","authors":"Karl-Ernst Grund, Annette Zipfel, Wolfgang H Jost","doi":"10.1055/a-2337-3433","DOIUrl":"10.1055/a-2337-3433","url":null,"abstract":"<p><p>The various forms of Percutaneous Endoscopic Gastrostomy (PEG) are highly relevant in neurology, as pump-administered intrajejunal levodopa application is one of the indispensable forms of therapy in advanced Parkinson's disease. Optimal PEG placement and follow-up are therefore significant for the success of the therapy. However, the standard intrajejunal administration of levodopa gel via a JET-PEG, i. e. a PEG with an internal catheter inserted into the jejunum, is not without problems for various reasons. In particular, the considerable cumulative complication rates demand a reconsideration of the situation. The very limited absorption area of the drug in the region of the flexura duodenojejunalis must also be taken into account. Causes of complications are predominantly a non-optimal application technique of PEG and internal catheter as well as the frequent lack of an adequate follow-up. In this paper, the details of a modified and optimized application technique compared to the conventional techniques are presented. These new methods have proved their usefulness in clinical applications for years, and additionally a new application form, the Hybrid-PEG, is presented. However, many of the details derived from anatomical/physiological, surgical and endoscopic aspects must be strictly observed during the application in order to reduce or avoid minor and major complications. In particular, problems are caused by local infections in the area of the insertion point of the PEG including peritonitis, leaks and buried bumper syndrome (BBS). The relatively frequent dislocations of the internal catheter also prove to be particularly troublesome. These can ultimately be avoided by clip fixation of the catheter tip down in the jejunum. In particular, the use of the newly developed Hybrid-PEG, a combination of endoscopically controlled gastropexy with three sutures and subsequent central thread-pull-through of the PEG tube, can significantly reduce the complication rate and thus achieve a decisive improvement for patients. The aspects discussed here are highly relevant for all those involved in the therapy of advanced Parkinson's disease. Trustful interdisciplinary collaboration between neurology and endoscopy/surgery/gastroenterology is a prerequisite for good clinical outcomes.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"403-415"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mental disorders in epilepsy].","authors":"Norbert Bohnert, Peter Martin","doi":"10.1055/a-2586-7859","DOIUrl":"https://doi.org/10.1055/a-2586-7859","url":null,"abstract":"<p><p>Mental disorders frequently occur in patients with epilepsy. Their description, diagnosis and treatment play a central and increasingly important role in epileptology. Work has also been underway for some time to systematically investigate and classify the mental disorders that can occur in connection with epilepsy.Despite great efforts, much in this field is still vague and in the process of being developed.Translated with DeepL.com (free version).</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"93 10","pages":"416-431"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206009","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":"[Correction: Between health hazards and therapeutic hope: On the proper handling of psychotropic substances].","authors":"Joachim Klosterkötter, Jens Kuhn","doi":"10.1055/a-2796-2513","DOIUrl":"https://doi.org/10.1055/a-2796-2513","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"93 10","pages":"e5"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194498","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}