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Kognitive Defizite bei Multipler Sklerose

Cognitive dysfunctions in multiple sclerosis patients

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Zusammenfassung

Kognitive Defizite sind ein häufiges Symptom der Multiplen Sklerose (MS). Bis zu 65% der Patienten leiden unter kognitiven Teilleistungsdefiziten. Vorrangig sind Gedächtnis-, Aufmerksamkeits-, exekutive und visuokonstruktive Funktionen betroffen. Probleme in diesen Bereichen können die Arbeitsfähigkeit, soziale Beziehungen und die Lebensqualität deutlich beeinträchtigen. Die Symptome können sich weitestgehend unabhängig von physischer Beeinträchtigung manifestieren. Kognitive Leistungen sind, da sie als hochkomplexe Funktionen auf die Integrität neuronaler Netzwerke angewiesen sind, deutliche Krankheitsindikatoren der MS. Einmal außerhalb eines Schubes existent, bleiben sie in der Regel in ihrer Ausprägung manifest. Eine differenzierte Diagnostik vorausgesetzt, ist es möglich den kognitiven Defiziten durch medikamentöse Therapien (immunmodulatorische und symptomorientierte Medikation) und kognitives Training entgegenzuwirken. Die bisherigen therapeutischen Einflussmöglichkeiten sind jedoch limitiert. Die vorliegende Arbeit geht detailliert auf die speziell bei MS betroffenen Teilleistungsbereiche, deren differenzialdiagnostischen Abgrenzung zu Fatigue und Depressivität, auf die Diagnostik und therapeutischen Möglichkeiten der Beeinflussbarkeit ein.

Summary

Cognitive dysfunctions are frequent symptoms of multiple sclerosis (MS) and occur in up to 65% of patients. Especially memory, attention, executive and visual constructive functions are impaired. These problems strongly affect patients’ ability to work, social relationships, and quality of life. Symptoms of physical disabilities can arise independently. Cognitive dysfunctions are clear indicators of MS progression, since they represent highly complex functions depending on the integrity of neuronal networks. Once manifested after a relapse, they remain stable. Given a differentiating diagnosis, it is possible to treat these dysfunctions by cognitive training and pharmacologically for example by immunomodulating drugs. However, treatment options are limited at present. This report provides a detailed description of cognitive functions and performance in MS patients, their comorbidities such as fatigue and depression, currently available diagnostic tools, and therapeutic options.

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  1. Klinik und Poliklinik für Neurologie der Universität Rostock

    C. Engel, B. Greim & U. K. Zettl

  2. Klinik und Poliklinik für Neurologie, Universität Rostock, Gehlsheimer Straße 20, 18147, Rostock, Deutschland

    C. Engel

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Engel, C., Greim, B. & Zettl, U.K. Kognitive Defizite bei Multipler Sklerose. Nervenarzt 76, 943–953 (2005). https://doi.org/10.1007/s00115-005-1901-1

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