Fortschritte der Neurologie · Psychiatrie最新文献

{"title":"[Down Syndrome and Alzheimer Dementia].","authors":"Claus-W Wallesch","doi":"10.1055/a-1895-6817","DOIUrl":"https://doi.org/10.1055/a-1895-6817","url":null,"abstract":"Die Lebenserwartung von Menschen mit Down-Syndrom ist in den letzten Jahrzehnten\u0000 deutlich gestiegen und beträgt aktuell etwa 60 Jahre 1. In Deutschland leben etwa 50.000 Menschen mit\u0000 Trisomie 21. Da das Amyloid Precursor Protein Gen sich auf Chromosom 21 befindet,\u0000 haben Menschen mit Down-Syndrom ein hohes Risiko, an einer Alzheimer-Demenz zu\u0000 erkranken. In einer Längsschnittstudie waren 23% der\u0000 (überlebenden) Menschen mit Down-Syndrom mit 50 Jahren, 45% mit 55\u0000 Jahren und 88% mit 65 Jahren an Demenz erkrankt 2. Menschen mit Down Syndrom machen einen großen Teil\u0000 präseniler Alzheimer-Erkrankungen aus. Histologisch finden sich\u0000 Amyloidablagerungen bei praktisch allen Menschen mit Down-Syndrom ab dem 30.\u0000 Lebensjahr 3.","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"394-395"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnosing Alzheimer Dementia in People with Down Syndrome in Accordance with ICD, DSM V and A/T/N System].","authors":"Georg Nübling,&nbsp;Olivia Wagemann,&nbsp;Sandra V Loosli,&nbsp;Elisabeth Wlasich,&nbsp;Adrian Danek,&nbsp;Johannes Levin","doi":"10.1055/a-1771-6273","DOIUrl":"https://doi.org/10.1055/a-1771-6273","url":null,"abstract":"<p><p>Due to a triplication of the amyloid precursor protein (APP) gene on chromosome 21, most people with Down's Syndrome (DS) are at high risk of developing an Alzheimer type of dementia associated with Down's Syndrome (DS-AD). The diagnostic process of DS-AD is challenging due to the high variability of symptoms ranging from memory deficits to social withdrawal or aggression, as well as a broad spectrum of differential diagnoses. Currently, ICD-10, DSM-V and the novel A(amyloid)/T(tau)/N (neurodegeneration) system are available for classifying dementia, although DS-AD is not represented as a specific entity in any of these systems. Here, we discuss challenges in arriving at a diagnosis of Alzheimer dementia in people with DS in accordance with these diagnostic systems.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"416-420"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Orthostatic Intolerance: A Clinical Approach].","authors":"Anke Lührs,&nbsp;Carl-Albrecht Haensch","doi":"10.1055/a-1803-8901","DOIUrl":"https://doi.org/10.1055/a-1803-8901","url":null,"abstract":"<p><p>Having suffered a syncope or dizziness are frequent reasons for admissions to an emergency ward. Carefully taken anamnesis and clinical examination are mostly leading to a correct diagnosis. Red flags like new ECG changes, syncope during physical activity or others should lead to further diagnostic steps. Orthostatic intolerance is one of the most common reasons for dizziness and/or syncope. Autonomic testing including tilt table testing has to be done carefully and judged in an overall view together with anamnesis and clinical presentation. We present a clinical approach to the wide field of orthostatic intolerance with hints for the need of further autonomic testing.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"368-379"},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40608514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kognitive Interventionen bei der Alzheimer-Krankheit.","authors":"Daniela Frimmer, Katharina Buerger","doi":"10.1055/a-1869-4377","DOIUrl":"10.1055/a-1869-4377","url":null,"abstract":"<p><p>Cognitive interventions (CI) are an important part in the treatment of Alzheimer's disease (AD). These non-pharamcological treatment options are manifold and can be matched to a patient's particular symptoms and needs. This article gives an overview of CIs and their theoretical background, as well as empirical evidence concerning their efficacy at different stages of the disease. Specific determinants of their effectiveness and possible clinical applications are discussed, while also recent developments, such as computer-based CIs, are considered.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"344-351"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40608512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Dementia: Current Status].","authors":"Joachim Klosterkötter,&nbsp;Frank Jessen","doi":"10.1055/a-1825-1073","DOIUrl":"https://doi.org/10.1055/a-1825-1073","url":null,"abstract":"Demenzerkrankungen stellen eine erhebliche Herausforderung für Betroffene\u0000 und deren Angehörige sowie auf Grund der demographischen Entwicklung auch\u0000 für das Gesundheitssystem und die gesamte Gesellschaft dar. Dementsprechend\u0000 entwickelt sich die Forschung, insbesondere im Bereich der Diagnostik und\u0000 Früherkennung der Alzheimer-Krankheit, rasant. Im Bereich der\u0000 Therapieentwicklung gibt es ebenfalls bereits große Erfolge, wie dies\u0000 besonders die Möglichkeit, Amyloid im Gehirn bei der Alzheimer Erkrankung zu\u0000 senken, eindrucksvoll deutlich macht. Gleichzeitig hat das Feld aber\u0000 gegenwärtig auch noch stark mit dem Problem nicht ausreichend\u0000 überzeugender Ergebnisse in Bezug auf die klinische Effektivität\u0000 dieser Ansätze zu kämpfen. Vor dem Hintergrund dieser spannenden\u0000 Entwicklungen widmet sich das vorliegende Sonderheft der Fortschritte dem\u0000 Thema der Demenz und im Speziellen der Alzheimer-Krankheit.","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"318-319"},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40608510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Cost of Early Diagnosis of Cognitive Decline in German Memory Clinics].","authors":"Oezguer A Onur,&nbsp;Claus Wolff-Menzler,&nbsp;Christine A F von Arnim,&nbsp;Frank Jessen,&nbsp;Gereon R Fink,&nbsp;Jens Wiltfang,&nbsp;Christoph Laske,&nbsp;Anja Schneider,&nbsp;Johannes Levin,&nbsp;Timo Oberstein,&nbsp;Johannes Kornhuber,&nbsp;Felix Oberhauser,&nbsp;Jürgen Gallinat,&nbsp;Richard Dodel,&nbsp;Markus Otto,&nbsp;Oliver Peters,&nbsp;Stefan Teipel,&nbsp;Emrah Duezel,&nbsp;Matthias Riemenschneider,&nbsp;Agnes Flöel,&nbsp;Robert Perneczky,&nbsp;Kathrin Reetz,&nbsp;Jörg B Schulz,&nbsp;Lucrezia Hausner,&nbsp;Timo Grimmer,&nbsp;Lutz Frölich","doi":"10.1055/a-1871-9889","DOIUrl":"https://doi.org/10.1055/a-1871-9889","url":null,"abstract":"<p><p>Dementias are expensive diseases: the net annual cost in European healthcare is about € 28.000 per case with a strong stage dependency, of which medical care accounts for about 19%. Diagnostic costs, on the other hand, account for only a small proportion of the total costs. With changes in the guidelines, biomarker tests are becoming increasingly important. At present, the concrete economic impact of biomarker-based diagnosis is largely unknown. To determine the actual costs of diagnostic procedures based on guidelines, we conducted a survey among the members of the German Memory Clinic Network (DNG). From 15 expert centres, the staff engagement time for all procedures was collected. Based on the individual engagement times of the different professions, the total of personnel costs for diagnostics was calculated using current gross personnel costs. The total sum of diagnostic costs (personnel plus procedures) was calculated for three different scenarios e. g. € 633,97 for diagnostics without biomarkers, € 1.214,90 for diagnostics with CSF biomarkers and € 4.740,58 € for diagnostics with FDG- plus Amyloid-PET. In addition, the actual diagnostic costs of the current practice in expert memory clinics were estimated, taking into account personnel costs, costs for the different procedures and the frequency of their use across all patients. This results in total average costs of € 1.394,43 per case as the mean across all centres (personnel costs € 351,72, costs for diagnostic procedures € 1.042,71). The results show that state-of-the-art diagnosis of dementia and pre-dementia states, such as mild cognitive impairment (MCI) requires financial resources, which are currently not fully reimbursed in Germany. The need for a biomarker-based etiological diagnosis of dementia and pre-dementia states will increase, due to availability of disease-modifying treatments. Therefore, the current gap of reimbursement must be filled by new models of compensation.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"361-367"},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40608513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Blood Based Biomarker for Optimization of Early and Differential Diagnosis of Alzheimer's Dementia].","authors":"Niels Hansen,&nbsp;Carolin Rauter,&nbsp;Jens Wiltfang","doi":"10.1055/a-1839-6237","DOIUrl":"https://doi.org/10.1055/a-1839-6237","url":null,"abstract":"<p><strong>Aim: </strong>Dementia in Alzheimer´s disease is a global challenge. There is growing evidence that investigating blood biomarkers to diagnose Alzheimer´s disease is a promising fast, minimally invasive, and less costly method. The aim of this study was to review available studies on promising biomarkers for Alzheimer´s disease.</p><p><strong>Method: </strong>The latest studies were collated for this review.</p><p><strong>Results: </strong>Immunoassays followed by mass spectrometry and immunomagnetic reduction were reported to be highly relevant methods for detecting amyloid-ß 42 (Aß42) and amyloid-ß 40 (Aß40) to calculate the Aß42/Aß40 ratio, thereby improving the early diagnosis of Alzheimer´s disease. Amyloid-ß (Aß) peptides in blood plasma were considered as potential markers, as they correlated with the brain's Aß pathology. Phosphorylated tau protein 181 (p-tau181), phosphorylated tau protein 217 (p-tau217) and phosphorylated tau protein 231 (p-tau231) in blood samples assessed via Simoa technology served as parameters for the early and differential diagnosis of AD, and were markers of tau pathology in the brain. Neurofilament light chain (Nfl) and glial fibrillary acid protein (GFAP) were additional markers possibly facilitating the assessment of axonal and astroglial brain damage in Alzheimer´s disease. GFAP in blood was useful as an additional marker to detect early and to predict the time course of Alzheimer´s disease.</p><p><strong>Conclusions: </strong>Determining blood biomarkers represents less invasive and less costly diagnostics for Alzheimer´s disease. The investigation of blood biomarkers such as the Aß42/Aß40 ratio, p-tau217, p-tau231, Nfl and GFAP have been promising in establishing the AT(N) classification for Alzheimer´s disease. High-throughput methods should be evaluated in large patient cohort studies and via meta-analyses of studies. Consensus criteria with standard protocols for measuring these biomarkers while considering ethical issues and Alzheimer´s phenotype should unify normative values from different laboratories. The AT(N) classification of Alzheimer´s disease in blood would be a key element towards the implementation of minimally-invasive precision medicine.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"326-335"},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40608511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk assessment for domestic violence].","authors":"F Kilvinger,&nbsp;A Rossegger,&nbsp;F Urbaniok,&nbsp;J Endrass","doi":"10.1055/s-0031-1273200","DOIUrl":"https://doi.org/10.1055/s-0031-1273200","url":null,"abstract":"The aim of the present study is to give a systematic overview of risk assessment instruments for the field of domestic violence. Six instruments were identified, which had been published in a peer-reviewed journal and for which validation studies exist: the Domestic Violent Screening Instrument (DVSI), the Danger Assessment (DA), the Spousal Assault Risk-Assessment (SARA), the Ontario Domestic Assault Risk-Assessment (ODARA), the Violence Risk Appraisal Guide (VRAG), and the Domestic Violence Risk Appraisal Guide (DVRAG). Their validity and practical use are discussed.","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"312-9"},"PeriodicalIF":0.6,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0031-1273200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40091025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[\"Fortschritte\" opens new platform for english language submissions].","authors":"J Klosterkötter","doi":"10.1055/s-0031-1299453","DOIUrl":"https://doi.org/10.1055/s-0031-1299453","url":null,"abstract":"Korrespondenzadresse Prof. Dr. med. Joachim Klosterkötter Klinik und Poliklinik für Psychiatrie, Universität zu Köln Kerpener Straße 62 50924 Köln Joachim. klosterkötter@uk-koeln.de Als 1929 unsere traditionsreiche Zeitschrift zum erstenMal erschien, eröffneten die Gründungsherausgeber den ersten Jahrgang mit einer Einführung, die ihre publikatorischen Zielsetzungen beschrieb. Das neu geschaffene Publikationsorgan sollte „dem allgemein verbreiteten Wunsche“ entsprechen, „einen Überblick“ über den „gesamten Gegenstandsbereich“ der Neurologie und Psychiatrie „zu bekommen und dauernd zu behalten“. Wer derart umfassend informiert sein und dies auch bleiben wollte, hätte sonst damals nur die zahlreichen Spezial-Referate in den sogenannten Zentralblättern sowie natürlich immer wieder auch die von Zeit zu Zeit erscheinenden Handbücher durchstudieren können. Diese oft zu speziellen oder zu breiten und für viel beschäftigte Praktiker nur schwer nutzbaren Informationsquellen wollten die Gründungsherausgeber nun durch eine Fachzeitschrift ergänzen, die sich an den „großen Entwicklungslinien“ orientiert, sie ihren Lesern in ebenso substanzreichen wie gut lesbaren Übersichtsreferaten vor Augen führt und daneben auch originale Forschungsergebnisse zu wichtigen Fragestellungen präsentiert [1]. Auch den 80. Jahrgang der „Fortschritte Neurologie – Psychiatrie“ 2012 hätte man durchaus wieder mit ähnlichen Überlegungen zur Zielsetzung unserer Zeitschrift eröffnen können. Im Kern sind alle nachfolgenden Herausgebergruppen über die vielen zwischenzeitlichen Jahrgänge hinweg und auch über die offizielle Fächertrennung hinaus der Gründungsprogrammatik mit ihrem Bezug auf den inneren Zusammenhang des Gesamtgebiets wie beispielsweise bei der Demenz [2–4] treu geblieben. Dass Fachzeitschriften die sonstigen Informationsquellen in sinnvoller Weise ergänzen und einemweit verbreitetenWunsch nach Überblicksvermittlung entgegenkommen, hat sich seit den Gründerzeiten der traditionsreichsten Journale eindeutig und nachhaltig bestätigt. Heute nutzen fast alle niedergelassenen Nervenärzte, Neurologen und Psychiater dieses Informationsmedium, zu rund 75% sogar „intensiv“, und noch verbreiteter ist die intensive Nutzung bei den Chefund Oberärzten der entsprechenden Fachkliniken [5]. Allerdings lässt sich eine gravierende Veränderung gegenüber den Gründerzeiten der deutschsprachigen Fachzeitschriften schon seit vielen Jahren gar nicht mehr übersehen. Das internationalisierte Englisch ist inzwischen weltweit zur dominierenden Wissenschaftssprache aufgestiegen und man muss sich deshalb fragen, ob eine Zeitschrift mit dem skizzierten anspruchsvollen Programm weiterhin auf deutschsprachige Publikationen beschränkt bleiben kann. Die „Fortschritte“ richten sich nunmehr schon im 80. Jahrgang vorrangig an die deutschsprachige Leserschaft mit ihrem Erfahrungshintergrund, und es wäre deshalb sicherlich ganz verfehlt, diese tragende Verbindung durch einen Wechsel der Publikationssprache zu ersc","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"191-2"},"PeriodicalIF":0.6,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0031-1299453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39971921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Acute neuropathy with tetraparesis and respiratory insufficiency in cases of acute intermittent porphyria].","authors":"A Diels,&nbsp;G R Fink,&nbsp;M Faust,&nbsp;L Burghaus","doi":"10.1055/s-0031-1281793","DOIUrl":"https://doi.org/10.1055/s-0031-1281793","url":null,"abstract":"<p><p>Acute intermittent porphyria is a hereditary disorder resulting from a partial deficiency of the third enzyme in the haeme biosynthetic pathway. Symptoms are due to metabolic effects on the peripheral autonomic and sensomotoric, as well as the central nervous system. We report on the case of a life-threatening acute crisis with tetraplegia and respiratory insufficiency.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"221-6"},"PeriodicalIF":0.6,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0031-1281793","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39972563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}